FLS Module 3 - basic laparoscopic
procedures – QUESTIONS WITH
ANSWERS
What are some of the newest developments in
laparoscopic surgery? - CORRECT ANSWERS ✔✔Robotic
assistance, single port site procedures, Natural Orifice
Translumenal Endoscopic Surgery (NOTES), and
intrauterine fetal surgery
List 5 laparoscopic procedures that are performed on
newborn infants - CORRECT ANSWERS ✔✔appendectomy,
undescended testes, anti-reflux surgery, pectus repair,
PDA, intestinal atresia, pyloromyotomy, and surgery for
Hirschsprung's disease
Indications for diagnostic laparoscopy - CORRECT
ANSWERS ✔✔elective - cancer staging, chronic abdominal
pain
urgent - small bowel obstruction, vs ileus
Emergent - trauma, suspected iatrogenic injury,
perforated viscous
During what procedures could you inadvertently enter the
peritoneal cavity and subsquently need to perform a
,diagnostic laparoscopy? - CORRECT ANSWERS
✔✔hysteroscopy, endoscopy
Key elements of performing a lysis of adhesions -
CORRECT ANSWERS ✔✔Use both blunt and sharp
dissection with gentle traction on tissue. Be cautious and
sparingly use energy sources for hemostasis to avoid
thermal spread
What is the best position for patients getting surgery on
the upper abdomen? - CORRECT ANSWERS ✔✔Arms on
arm boards, reverse trendelenburg position with a
footboard and safety strap on lower thighs to keep
patient from sliding. Monitors placed at head of table for
viewing operative field.
What is the key to patient positioning? Where would you
place your initial port for a diagnostic lap where you need
to view the entire abdomen? After your initial port, where
do you place additional ones? - CORRECT ANSWERS
✔✔Maximize the ergonomics of the surgeon and
assistant. Usually initiate access in LUQ and 2 additional
ports can also be placed in the left abdomen (then
surgeon and assistant can stand on left side together).
This allows the entire abdomen to be visualized except
for immediately below the ports or lateral to the ports.
, General principles of diagnostic lap of the liver - CORRECT
ANSWERS ✔✔Angled scope
Tools for biospy and hemostasis
May need ultrasound to visualize structures under the
surface.
To see anteriorly: may need adhesiolysis
To see posteriorly: may need special liver retractor or
careful use of blunt instruments
Why would you do a diagnostic lap of the anterior
abdominal wall?
What area should you enter the abdomen?
What degree scope should you use? - CORRECT
ANSWERS ✔✔To look for evidence of post-op bleeding,
adhesions, hernia or tumor.
Left upper quadrant, unless the area of interest is in the
LUQ.
30 degree scope
Best position and port placement for diagnostic pelvic
laparoscopy - CORRECT ANSWERS ✔✔- Tucked arms so
surgeon can be ergonomically favorable.
- Trendelenburg
- Ports at or above the umbilicus
procedures – QUESTIONS WITH
ANSWERS
What are some of the newest developments in
laparoscopic surgery? - CORRECT ANSWERS ✔✔Robotic
assistance, single port site procedures, Natural Orifice
Translumenal Endoscopic Surgery (NOTES), and
intrauterine fetal surgery
List 5 laparoscopic procedures that are performed on
newborn infants - CORRECT ANSWERS ✔✔appendectomy,
undescended testes, anti-reflux surgery, pectus repair,
PDA, intestinal atresia, pyloromyotomy, and surgery for
Hirschsprung's disease
Indications for diagnostic laparoscopy - CORRECT
ANSWERS ✔✔elective - cancer staging, chronic abdominal
pain
urgent - small bowel obstruction, vs ileus
Emergent - trauma, suspected iatrogenic injury,
perforated viscous
During what procedures could you inadvertently enter the
peritoneal cavity and subsquently need to perform a
,diagnostic laparoscopy? - CORRECT ANSWERS
✔✔hysteroscopy, endoscopy
Key elements of performing a lysis of adhesions -
CORRECT ANSWERS ✔✔Use both blunt and sharp
dissection with gentle traction on tissue. Be cautious and
sparingly use energy sources for hemostasis to avoid
thermal spread
What is the best position for patients getting surgery on
the upper abdomen? - CORRECT ANSWERS ✔✔Arms on
arm boards, reverse trendelenburg position with a
footboard and safety strap on lower thighs to keep
patient from sliding. Monitors placed at head of table for
viewing operative field.
What is the key to patient positioning? Where would you
place your initial port for a diagnostic lap where you need
to view the entire abdomen? After your initial port, where
do you place additional ones? - CORRECT ANSWERS
✔✔Maximize the ergonomics of the surgeon and
assistant. Usually initiate access in LUQ and 2 additional
ports can also be placed in the left abdomen (then
surgeon and assistant can stand on left side together).
This allows the entire abdomen to be visualized except
for immediately below the ports or lateral to the ports.
, General principles of diagnostic lap of the liver - CORRECT
ANSWERS ✔✔Angled scope
Tools for biospy and hemostasis
May need ultrasound to visualize structures under the
surface.
To see anteriorly: may need adhesiolysis
To see posteriorly: may need special liver retractor or
careful use of blunt instruments
Why would you do a diagnostic lap of the anterior
abdominal wall?
What area should you enter the abdomen?
What degree scope should you use? - CORRECT
ANSWERS ✔✔To look for evidence of post-op bleeding,
adhesions, hernia or tumor.
Left upper quadrant, unless the area of interest is in the
LUQ.
30 degree scope
Best position and port placement for diagnostic pelvic
laparoscopy - CORRECT ANSWERS ✔✔- Tucked arms so
surgeon can be ergonomically favorable.
- Trendelenburg
- Ports at or above the umbilicus
