FLS Exam Questions and Answers
100% Pass
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
Katelyn Whitman, All Rights Reserved © 2025 1
,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
Katelyn Whitman, All Rights Reserved © 2025 2
,- 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
Direct coupling - ✔✔monopolar instrument in direct contact w/ metal portion of
another instrument
Besides capacitative coupling and direct coupling, other hazards of electrocautery - ✔✔-
Current diversion
- Narrow return circuit
Bipolar - ✔✔- forceps w/ two twins (one active other return)
- no pt return electrode required)
Katelyn Whitman, All Rights Reserved © 2025 3
, - no capacitative coupling
- works in "wet" operative field
- less thermal spread compared to monopolar
bipolar seals vessels up to _____ mm in diameter - ✔✔7 mm
ultrasonic coagulation shears seals vessels up to ____ mm in diameter - ✔✔5 mm
ultrasonic coagulation shears - ✔✔- combo compression and friction
- ONE active blade
- monopolar capacity w/ the one blade
- no capacitative coupling
- high power (MAX): cut
- low power (MIN): coag
How many days prior to surgery does warfarin has to be discontinued? - ✔✔3 days
ASA 2 - ✔✔Mild to moderate systemic disease
ASA 3 - ✔✔severe systemic disease that limits patient activity, may or may not be
related to reason for surgery
ASA 4 - ✔✔Severe systemic disturbances that limit patient and are life-threatening with
or without surgery
Katelyn Whitman, All Rights Reserved © 2025 4
100% Pass
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
Katelyn Whitman, All Rights Reserved © 2025 1
,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
Katelyn Whitman, All Rights Reserved © 2025 2
,- 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
Direct coupling - ✔✔monopolar instrument in direct contact w/ metal portion of
another instrument
Besides capacitative coupling and direct coupling, other hazards of electrocautery - ✔✔-
Current diversion
- Narrow return circuit
Bipolar - ✔✔- forceps w/ two twins (one active other return)
- no pt return electrode required)
Katelyn Whitman, All Rights Reserved © 2025 3
, - no capacitative coupling
- works in "wet" operative field
- less thermal spread compared to monopolar
bipolar seals vessels up to _____ mm in diameter - ✔✔7 mm
ultrasonic coagulation shears seals vessels up to ____ mm in diameter - ✔✔5 mm
ultrasonic coagulation shears - ✔✔- combo compression and friction
- ONE active blade
- monopolar capacity w/ the one blade
- no capacitative coupling
- high power (MAX): cut
- low power (MIN): coag
How many days prior to surgery does warfarin has to be discontinued? - ✔✔3 days
ASA 2 - ✔✔Mild to moderate systemic disease
ASA 3 - ✔✔severe systemic disease that limits patient activity, may or may not be
related to reason for surgery
ASA 4 - ✔✔Severe systemic disturbances that limit patient and are life-threatening with
or without surgery
Katelyn Whitman, All Rights Reserved © 2025 4
