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Question 13
Anatomy → Abdominal wall
Classification
Question
SSBAQuestion Header
A primary laparoscopic port is planned through the middle upper abdomen at a point midway between the xiphoid process and the umbilicus. Which named access point is being used?
Question Stem
A) Palmer's point
B) Jain point
C) Lee-Huang point
D) McBurney's point
E) Umbilical point
B) Jain point
C) Lee-Huang point
D) McBurney's point
E) Umbilical point
Options
A
Palmer's point
B
Jain point
C
Lee-Huang point
D
McBurney's point
E
Umbilical point
Explanation
The Lee-Huang point is a middle upper abdominal access location for Veress needle or primary port insertion. It is situated midway between the xiphoid process and the umbilicus. This distinguishes it from Palmer's point, which lies 3 cm below the left subcostal margin in the midclavicular line, and from the Jain point, which is a left paraumbilical location described in relation to the anterior superior iliac spine. The umbilicus remains the most common general site for Veress needle insertion but is not the named middle upper abdominal point described. Recognising these named access sites and their precise surface anatomy is useful when alternative laparoscopic entry locations are required.
Option Validity
A) Palmer's point is located in the left upper quadrant below the left subcostal margin.
B) The Jain point is left paraumbilical and defined relative to the anterior superior iliac spine.
D) McBurney's point is not an appropriate laparoscopic access point in this context.
E) The umbilical point is the common standard site but not the midpoint between xiphoid and umbilicus.
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