FLS EXAM MODULES QUESTIONS
WITH DETAILED VERIFIED ANSWERS
absolute contraindications to blind veress needle
insertion points - correct answer- 1. insertion
into abdominal scar from prior open operation
2. through previously placed intraperitoneal mesh for
hernia repair
allen stirrups - correct answer- better than
candy cane as they have better individualization,
especially in longer procedures
alternative gases: Argon and Helium - correct
answer- eliminate the complication of acidosis, but
are much less soluble in blood. Decreased solubility
increases the risk of extra-peritoneal gas extravasation
(gas embolus)
Alternative gases: NO - correct answer-
benefits: less acid-base disturbance, increased patient
,tolerability in patients with severe cardio pulmonary
disease, less post op pain
risks: fire hazard with electrocautery, cannot be used with
suspected bowel perf
anterior abdominal wall dx lap - correct answer-
to look for post op bleeding, adhesions, hernia or tumor.
use angled scope.
ASA level not appropriate for lap surgery - correct
answer- 4-5, might not be able to tolerate
pneumoperitoneum due to decreased venous return and
need for hyperventilation
benefits of braided suture - correct answer-
easier to handle, lack elastic memory, don't fray
biopsy forceps - correct answer- for incisional
or excisional, or peritoneal implants.
,biopsy methods and what to avoid - correct
answer- 1. peritoneal washings
2. FNA
3. Core needle
4. incisional (wedge)
5. excisional
avoid electrocautery
biopsy of visceral lesions - correct answer- if
small and superficial can excise, use serosal stitch to avoid
leakage
bipolar definition - correct answer- tissue is
placed between two electrodes. current flows only
through the tissue contiguous with both electrodes. lower
energy requirement, less lateral tissue damage.
Can seal vessels up to 7mm
, bipolar energy delivery - correct answer-
computer measures tissue impedance of grasped
tissue--.controlled energy delivery--> denaturation of
collagen-->creation of permanent seal
bipolar hazards: improper functioning if metal is within
the jaws - correct answer- including clips or
staples
bipolar hazards: inadvertent cutting of vessels before
adequate sealing - correct answer- make sure
to complete entire activation cycle prior to cutting
bipolar hazards: inadvertent thermal injury - correct
answer- avoid activating the device in close
proximity to adjacent organs
cardiac arrhythmia due to pneumoperitoneum (3) -
correct answer- 1. sinus tach (most common,
self limited)
2. PVCs
WITH DETAILED VERIFIED ANSWERS
absolute contraindications to blind veress needle
insertion points - correct answer- 1. insertion
into abdominal scar from prior open operation
2. through previously placed intraperitoneal mesh for
hernia repair
allen stirrups - correct answer- better than
candy cane as they have better individualization,
especially in longer procedures
alternative gases: Argon and Helium - correct
answer- eliminate the complication of acidosis, but
are much less soluble in blood. Decreased solubility
increases the risk of extra-peritoneal gas extravasation
(gas embolus)
Alternative gases: NO - correct answer-
benefits: less acid-base disturbance, increased patient
,tolerability in patients with severe cardio pulmonary
disease, less post op pain
risks: fire hazard with electrocautery, cannot be used with
suspected bowel perf
anterior abdominal wall dx lap - correct answer-
to look for post op bleeding, adhesions, hernia or tumor.
use angled scope.
ASA level not appropriate for lap surgery - correct
answer- 4-5, might not be able to tolerate
pneumoperitoneum due to decreased venous return and
need for hyperventilation
benefits of braided suture - correct answer-
easier to handle, lack elastic memory, don't fray
biopsy forceps - correct answer- for incisional
or excisional, or peritoneal implants.
,biopsy methods and what to avoid - correct
answer- 1. peritoneal washings
2. FNA
3. Core needle
4. incisional (wedge)
5. excisional
avoid electrocautery
biopsy of visceral lesions - correct answer- if
small and superficial can excise, use serosal stitch to avoid
leakage
bipolar definition - correct answer- tissue is
placed between two electrodes. current flows only
through the tissue contiguous with both electrodes. lower
energy requirement, less lateral tissue damage.
Can seal vessels up to 7mm
, bipolar energy delivery - correct answer-
computer measures tissue impedance of grasped
tissue--.controlled energy delivery--> denaturation of
collagen-->creation of permanent seal
bipolar hazards: improper functioning if metal is within
the jaws - correct answer- including clips or
staples
bipolar hazards: inadvertent cutting of vessels before
adequate sealing - correct answer- make sure
to complete entire activation cycle prior to cutting
bipolar hazards: inadvertent thermal injury - correct
answer- avoid activating the device in close
proximity to adjacent organs
cardiac arrhythmia due to pneumoperitoneum (3) -
correct answer- 1. sinus tach (most common,
self limited)
2. PVCs
