SBA — Single Best Answer · Review
Question 11
Anatomy → Abdominal wall
Classification
Question
SSBAQuestion Header
A patient with concern about injury from blind primary laparoscopic access is planned for entry under direct vision. Which technique specifically avoids the blind insertion steps of the Veress needle and primary trocar?
Question Stem
A) Closed Veress technique
B) Direct trocar technique
C) Open Hasson technique
D) Radially expanding access technique
E) Optical access after blind Veress insufflation
B) Direct trocar technique
C) Open Hasson technique
D) Radially expanding access technique
E) Optical access after blind Veress insufflation
Options
A
Closed Veress technique
B
Direct trocar technique
C
Open Hasson technique
D
Radially expanding access technique
E
Optical access after blind Veress insufflation
Explanation
The open Hasson technique involves making an incision in the anterior abdominal wall and entering the peritoneal cavity under direct vision. This approach avoids the blind insertion steps associated with the Veress needle and primary trocar. The closed Veress technique relies on blind Veress needle insertion. Direct trocar entry reduces the number of blind steps but the trocar itself is still inserted without the same open exposure. Radially expanding access begins with Veress needle insufflation, while optical systems permit visualisation of layers during specialised trocar entry but are not equivalent to the open Hasson approach. Thus, when avoidance of the blind Veress and primary trocar steps is the defining objective, the open Hasson technique is the best answer.
Option Validity
A) The closed Veress technique itself uses blind Veress needle access.
B) Direct trocar entry reduces the sequence to one blind step rather than eliminating blind entry.
D) Radially expanding access begins with Veress needle insufflation.
E) This option still includes a blind Veress step and therefore does not meet the stated objective.
Further Reading
Part 1 MRCOG Revision Notes and Sample SBAs. Cambridge University Press, 2020. Section 1: Anatomy, Chapter 1. https://doi.org/10.1017/9781108644396