FLS TEST EXAM 2026|2027 UPDATED QUESTIONS WITH VERIFIED
ANSWERS (100% CORRECT ANSWERS) | ALREADY GRADED A+
What is the area for best placement of ports to view the kidneys and adrenal glands? - Correct Answer -
Along the costal margin
Mention the biopsy methods used in laparoscopy - Correct Answer -Peritoneal washing and scrapings
FNA
Core needle biopsy (a form of incisional biopsy)
Incisional (wedge) biopsy
Excisional biopsy
FNA - Correct Answer -20-22 gauge needle
Need sufficient needle length (eg. spinal needle)
Plunger with finger loops os helpful
Diagnostic Laparoscopy for Retroperitoneal Structures BELOW aortic bifurcation - Position - Correct
Answer -Trendelenberg with or w/o lithotomy
Core needle biopsy - Correct Answer -14-18 gauge needle
1|Page
,Most commonly used for biopsy of the liver
More at risk for bleeding
Examination of the small intestine - Correct Answer -Position 2 monitors - one near head, one near feet
(best monitor position are by the Lt shoulder and Rt hip)
Place ports along Lt abdomen if feasible
Keep instrument tips in field of view as much as possible
Use graspers designed for atraumatic handling
Avoid torquing bowel wall with graspers
Handle mesenteric fat rather than bowel wall when possible
Handle dilated bowel with extreme caution
Start at cecum and work proximally
Diagnostic laparoscopy for small bowel obstruction - Correct Answer -Initial entry under direct
visualization
Begin examination of small bowel distantly (decompressed)
> start at the ileocecal valve with a relative collapsed bowel
Manipulate dilated small bowel with extreme caution
Perform instrument exchanges carefully due to decreased working space
Diagnostic Laparoscopy for Retroperitoneal Structures ABOVE aortic bifurcation - Position - Correct
Answer -Lateral position
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,Diagnostic Laparoscopy for Retroperitoneal Structures BELOW aortic bifurcation - Position - Correct
Answer -Trendelenburg with or without lithotomy
Biopsy forceps - Correct Answer -Jaws have a cutting rim and are hollowed out in the center to capture
and prevent crushing the tissue sample
Incisional - larger lesions
Excisional - small lesions
Wedge biopsy - Correct Answer -tissue sampling utilizing a scalpel, scissors or stapling device
Peritoneal washing - Correct Answer -Should be obtain early in staging laparoscopy
infuse at least 100cc of 0.9NSS (unless abundant ascites present)
+/- mixed sample with a heparin solution for proper cytologic examination
Biopsy of peritoneal lesions - Correct Answer -Small
Excisional biopsy of a single small lesion
> Biopsy forceps
3|Page
, > Grasper and scissors
Incisional biops of larger lesions
> Biopsy forceps
> Grasper and scissors
Able to remove through 5 or 10 mm port
Lymph node biopsy - Correct Answer -Excisional biopsy
Hemostasis
> Energy source - careful use during biopsy
> Topical hemostatic agent - useful after excision
Removal
> Smaller nodes - 10-12 mm port
> Larger nodes - specimen retrieval sac
Liver Biopsy - Parenchymal disease (cirrhosis) - Correct Answer -Core needle biopsy
Wedge biopsy of edge of liver
Liver biopsy - Small surface lesions - Correct Answer -Incisional or excisional biopsy
Core needle or wedge biopsy
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ANSWERS (100% CORRECT ANSWERS) | ALREADY GRADED A+
What is the area for best placement of ports to view the kidneys and adrenal glands? - Correct Answer -
Along the costal margin
Mention the biopsy methods used in laparoscopy - Correct Answer -Peritoneal washing and scrapings
FNA
Core needle biopsy (a form of incisional biopsy)
Incisional (wedge) biopsy
Excisional biopsy
FNA - Correct Answer -20-22 gauge needle
Need sufficient needle length (eg. spinal needle)
Plunger with finger loops os helpful
Diagnostic Laparoscopy for Retroperitoneal Structures BELOW aortic bifurcation - Position - Correct
Answer -Trendelenberg with or w/o lithotomy
Core needle biopsy - Correct Answer -14-18 gauge needle
1|Page
,Most commonly used for biopsy of the liver
More at risk for bleeding
Examination of the small intestine - Correct Answer -Position 2 monitors - one near head, one near feet
(best monitor position are by the Lt shoulder and Rt hip)
Place ports along Lt abdomen if feasible
Keep instrument tips in field of view as much as possible
Use graspers designed for atraumatic handling
Avoid torquing bowel wall with graspers
Handle mesenteric fat rather than bowel wall when possible
Handle dilated bowel with extreme caution
Start at cecum and work proximally
Diagnostic laparoscopy for small bowel obstruction - Correct Answer -Initial entry under direct
visualization
Begin examination of small bowel distantly (decompressed)
> start at the ileocecal valve with a relative collapsed bowel
Manipulate dilated small bowel with extreme caution
Perform instrument exchanges carefully due to decreased working space
Diagnostic Laparoscopy for Retroperitoneal Structures ABOVE aortic bifurcation - Position - Correct
Answer -Lateral position
2|Page
,Diagnostic Laparoscopy for Retroperitoneal Structures BELOW aortic bifurcation - Position - Correct
Answer -Trendelenburg with or without lithotomy
Biopsy forceps - Correct Answer -Jaws have a cutting rim and are hollowed out in the center to capture
and prevent crushing the tissue sample
Incisional - larger lesions
Excisional - small lesions
Wedge biopsy - Correct Answer -tissue sampling utilizing a scalpel, scissors or stapling device
Peritoneal washing - Correct Answer -Should be obtain early in staging laparoscopy
infuse at least 100cc of 0.9NSS (unless abundant ascites present)
+/- mixed sample with a heparin solution for proper cytologic examination
Biopsy of peritoneal lesions - Correct Answer -Small
Excisional biopsy of a single small lesion
> Biopsy forceps
3|Page
, > Grasper and scissors
Incisional biops of larger lesions
> Biopsy forceps
> Grasper and scissors
Able to remove through 5 or 10 mm port
Lymph node biopsy - Correct Answer -Excisional biopsy
Hemostasis
> Energy source - careful use during biopsy
> Topical hemostatic agent - useful after excision
Removal
> Smaller nodes - 10-12 mm port
> Larger nodes - specimen retrieval sac
Liver Biopsy - Parenchymal disease (cirrhosis) - Correct Answer -Core needle biopsy
Wedge biopsy of edge of liver
Liver biopsy - Small surface lesions - Correct Answer -Incisional or excisional biopsy
Core needle or wedge biopsy
4|Page
