FLS Exam Questions And Correct
Answers
What are the laparoscope diameters?
2-10mm
Which degree scope is best for a field in line with port?
0 degree
How to prevent fogging of scope?
Use anti fog solution or put scope in hot water/hot bath
What is the most commonly used light source?
300 W Xenon lamp
What if there is initial low pressure and high flow rate at entry?
Leak in insufflator circuit, make sure everything plugged in correctly
,Benefits of monopolar
Tissue is heated quickly, less thermal damage/coagulation
Monopolar voltage/frequency
Low voltage/High frequency
What does coagulation mode do?
Repid surface heating with shallow depth of necrosis, intermittent wave form with
higher voltage
Risk of monopolar
Current can be diverted through unintentional pathways, leading to inadvertent tissue
injury. Don't use hybrid ports that mix metal with plastic
Why do you need a grounding pad for monopolar?
Capacitative coupling - transfer of energy between two conductors separated by an
insulator, transfer to passive electrode. Can release with tissue injury, but no issue if
ground plate is working as capacitor can't store the charge
Benefits of bipolar
,lower energy, producing less lateral tissue damage and necrosis. Don't need a grounding
pad
Risk of bipolar
Risk of cutting patient vessels before adequate sealing, and device doesn't work if there
is metal between the jaws
Risk of ultrasonic dissection (harmonic)
Active blade can injure something due to high frequency (50mHz)
Discontinue aspirin day of surgery?
No
How to enter in patient with bowel obstruction?
Direct visualization
Cut vs Coag
cut - heat tissue quickly to convert cell water to steam, lysing the cell
Coag - heat more widely dispersed, less cutting action
, smaller tissue area, greater current density and faster heating
e.g. Bovie tip
Cut mode
- Low voltage
- High frequency
- Continuous waveform
- Heats tissue quickly; cell water converts to steam and causes cell to explode
Coagulation mode
- High voltage
- Low frequency
- Intermittent waveform
- Rapid tissue heating, shallow depth of necrosis
- Non-contact: relies on sparking to tissue
Capacitive coupling
Transfer current from active electrode through insulation to passive electrode-
electrode to plastic part another LSC instrument
- if constant contact w/ tissue will not store energy and no injury
Answers
What are the laparoscope diameters?
2-10mm
Which degree scope is best for a field in line with port?
0 degree
How to prevent fogging of scope?
Use anti fog solution or put scope in hot water/hot bath
What is the most commonly used light source?
300 W Xenon lamp
What if there is initial low pressure and high flow rate at entry?
Leak in insufflator circuit, make sure everything plugged in correctly
,Benefits of monopolar
Tissue is heated quickly, less thermal damage/coagulation
Monopolar voltage/frequency
Low voltage/High frequency
What does coagulation mode do?
Repid surface heating with shallow depth of necrosis, intermittent wave form with
higher voltage
Risk of monopolar
Current can be diverted through unintentional pathways, leading to inadvertent tissue
injury. Don't use hybrid ports that mix metal with plastic
Why do you need a grounding pad for monopolar?
Capacitative coupling - transfer of energy between two conductors separated by an
insulator, transfer to passive electrode. Can release with tissue injury, but no issue if
ground plate is working as capacitor can't store the charge
Benefits of bipolar
,lower energy, producing less lateral tissue damage and necrosis. Don't need a grounding
pad
Risk of bipolar
Risk of cutting patient vessels before adequate sealing, and device doesn't work if there
is metal between the jaws
Risk of ultrasonic dissection (harmonic)
Active blade can injure something due to high frequency (50mHz)
Discontinue aspirin day of surgery?
No
How to enter in patient with bowel obstruction?
Direct visualization
Cut vs Coag
cut - heat tissue quickly to convert cell water to steam, lysing the cell
Coag - heat more widely dispersed, less cutting action
, smaller tissue area, greater current density and faster heating
e.g. Bovie tip
Cut mode
- Low voltage
- High frequency
- Continuous waveform
- Heats tissue quickly; cell water converts to steam and causes cell to explode
Coagulation mode
- High voltage
- Low frequency
- Intermittent waveform
- Rapid tissue heating, shallow depth of necrosis
- Non-contact: relies on sparking to tissue
Capacitive coupling
Transfer current from active electrode through insulation to passive electrode-
electrode to plastic part another LSC instrument
- if constant contact w/ tissue will not store energy and no injury
