The invention relates to a medical instrument for producing an opening in a vessel or
organ wall, having a penetrating body that is attached on the distal side to a shaft
assembly having a shaft longitudinal axis and that has a first body section and a second body section adjoining the first body section on the proximal side, wherein the second body section delimits a cavity radially to the shaft longitudinal axis at least in some regions and has a
cutting blade radially surrounding the cavity on the proximal side. The invention is characterised in that the penetrating body is composed of at least a first and a second penetrating
body segment, which have a first and a second body section. The first body section of the first penetrating
body segment ends at the distal end with a tip, and the second body section delimits a first cavity at least in some regions and has a
cutting blade which radially surrounds the first cavity. The first body section of the second penetrating
body segment tapers in the distal direction in the cross-section and has a recess facing the first penetrating body segment on the distal side, into which recess the second body section of the first penetrating body segment can be partially inserted. Furthermore, the second body section delimits a second cavity in some regions and has a
cutting blade that radially surrounds the second cavity.