An illumination element such as an optical waveguide for illuminating a surgical field in a patient has a light input section, a light transmitting section, and a light output section. The light input section is optically coupled to a proximal section of the light transmitting section and inputs light into the illumination element. The light transmitting section transmits the light preferably by total internal reflection or by other transmission means. The light output section is adjacent a distal section of the light transmitting section which has a light extraction area from which the light exits with an energy density. The light extraction area is large enough to maintain the energy density at a level that prevents melting of the illumination element or burning of the patient, and the light extraction area has a profile that does not interfere with access to the surgical field.