SBA — Single Best Answer · Review
Question 16
Anatomy → Abdominal wall
Classification
Question
SSBAQuestion Header
During planning of primary closed laparoscopic access in a patient without previous abdominal surgery or other factors requiring an alternative entry site, which anatomical point is the most commonly used site for Veress needle insertion?
Question Stem
A) Palmer's point
B) Lee-Huang point
C) Jain point
D) Umbilical point
E) Left iliac fossa
B) Lee-Huang point
C) Jain point
D) Umbilical point
E) Left iliac fossa
Options
A
Palmer's point
B
Lee-Huang point
C
Jain point
D
Umbilical point
E
Left iliac fossa
Explanation
The umbilical point is the most commonly used site for Veress needle insertion during closed laparoscopic entry. The umbilicus provides a relatively direct route through the anterior abdominal wall. Alternative access points are used in selected circumstances. Palmer's point lies in the left upper quadrant, approximately 3 cm below the left subcostal margin in the midclavicular line, and is particularly useful in patients with obesity or previous laparotomy scars. The Lee-Huang point is located midway between the xiphoid process and the umbilicus, while the Jain point is a left paraumbilical access site defined in relation to the anterior superior iliac spine. Therefore, in the absence of a reason to select an alternative access site, the umbilical point is the standard and most common location for Veress needle insertion.
Option Validity
A) Palmer's point is an alternative left upper quadrant access site.
B) Lee-Huang point is a middle upper abdominal alternative access point.
C) Jain point is a left paraumbilical alternative access point.
E) the left iliac fossa is not identified as the standard Veress needle entry point.
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