This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Operative Gynecology, Subject name: Gynaecology & Obstetrics
Which of these is FALSE for laparoscopic hysterectomy? 
Select and explain. 
A. In case of a previous midline scar, a minilap incision may be taken at the umbilicus for primary canula, B. While placing lateral pos , inferior epigastric vessels are to be avoided, C. After opening retroperitoneal space, ureter is identified over medial leaf of broad ligament, D. In LAVH uterine vessels are ligated laparoscopically after skeletonisation
D: In LAVH uterine vessels are ligated laparoscopically after skeletonisation
Answer: D: In LAVH uterine vessels are ligated laparoscopically after skeletonisation 
Explanation: The umbilical site typically is used in patients without a previous history of surgery or intra-abdominal infection. In cases of previous surgery where there was a midline incision or a history of a pelvic-abdominal incision, an open laparoscopy (mini lap at umbilicus) is recommended or an alternate site can be chosen to introduce the primary cannula. The most impoant step when placing lateral pos is to avoid the inferior epigastric vessels, which are branches of the external iliac aery and vein. The retroperitoneal space is opened after ligation of utero-ovarian ligament and the ureter identified on the medial leaf of the broad ligament.