FLS {Fundamentals of Laparoscopic Surgery} Verified Multiple Choice and Conceptual Actual Exam
Questions With Reviewed 100% Correct Detailed Answers >> Guaranteed Pass!!Current Update
What are the laparoscope diameters? 2-10mm
Which degree scope is best for a field in
0 degree
line with port?
Use anti fog solution or put scope in hot
How to prevent fogging of scope?
water/hot bath
What is the most commonly used light
300 W Xenon lamp
source?
What if there is initial low pressure and Leak in insufflator circuit, make sure
high flow rate at entry? everything plugged in correctly
Tissue is heated quickly, less thermal
Benefits of monopolar
damage/coagulation
Monopolar voltage/frequency Low voltage/High frequency
Repid surface heating with shallow depth
What does coagulation mode do? of necrosis, intermittent wave form with
higher voltage
Current can be diverted through uninten-
tional pathways, leading to inadvertent
Risk of monopolar
tissue injury. Don't use hybrid ports that
mix metal with plastic
Capacitative coupling - transfer of energy
between two conductors separated by an
Why do you need a grounding pad for insulator, transfer to passive electrode.
monopolar? Can release with tissue injury, but no
issue if ground plate is working as capac-
itor can't store the charge
lower energy, producing less lateral tis-
Benefits of bipolar sue damage and necrosis. Don't need a
grounding pad
Risk of cutting patient vessels before ad-
Risk of bipolar equate sealing, and device doesn't work
if there is metal between the jaws
Active blade can injure something due to
Risk of ultrasonic dissection (harmonic)
high frequency (50mHz)
Discontinue aspirin day of surgery? No
, FLS {Fundamentals of Laparoscopic Surgery} Verified Multiple Choice and Conceptual Actual Exam
Questions With Reviewed 100% Correct Detailed Answers >> Guaranteed Pass!!Current Update
How to enter in patient with bowel ob-
Direct visualization
struction?
cut - heat tissue quickly to convert cell
water to steam, lysing the cell
Cut vs Coag
Coag - heat more widely dispersed, less
cutting action
smaller tissue area, greater current den-
e.g. Bovie tip
sity and faster heating
- Low voltage
- High frequency
Cut mode - Continuous waveform
- Heats tissue quickly; cell water converts
to steam and causes cell to explode
- High voltage
- Low frequency
- Intermittent waveform
Coagulation mode - Rapid tissue heating, shallow depth of
necrosis
- Non-contact: relies on sparking to tis-
sue
Transfer current from active electrode
through insulation to passive electrode-
electrode to plastic part another LSC in-
Capacitive coupling
strument
- if constant contact w/ tissue will not
store energy and no injury
monopolar instrument in direct contact
Direct coupling
w/ metal portion of another instrument
Besides capacitative coupling and di-
- Current diversion
rect coupling, other hazards of electro-
- Narrow return circuit
cautery
- forceps w/ two twins (one active other
return)
Bipolar - no pt return electrode required)
- no capacitative coupling
- works in "wet" operative field
, FLS {Fundamentals of Laparoscopic Surgery} Verified Multiple Choice and Conceptual Actual Exam
Questions With Reviewed 100% Correct Detailed Answers >> Guaranteed Pass!!Current Update
- less thermal spread compared to
monopolar
bipolar seals vessels up to mm in
7 mm
diameter
ultrasonic coagulation shears seals ves-
5 mm
sels up to mm in diameter
- combo compression and friction
- ONE active blade
- monopolar capacity w/ the one blade
ultrasonic coagulation shears
- no capacitative coupling
- high power (MAX): cut
- low power (MIN): coag
How many days prior to surgery does
3 days
warfarin has to be discontinued?
ASA 2 Mild to moderate systemic disease
severe systemic disease that limits pa-
ASA 3 tient activity, may or may not be related
to reason for surgery
Severe systemic disturbances that limit
ASA 4 patient and are life-threatening with or
without surgery
Little change for survival but surgery last
ASA 5
resort (resuscitative effort)
ASA 4 and 5
ASA classes that may not be appropriate
- body cannot handle decreased venous
for LSC sx
return, need for hyperventilation
Length of trocar needed for obese pt >100 mm
- Inability to tolerate laparotomy
- Hypovolemic shock
ABSOLUTE C/I to LSC Sx - Lack proper surgeon training/experi-
ence
- Lack appropriate institutional support
- Inability to tolerate GETA
- Long-standing peritonitis
Questions With Reviewed 100% Correct Detailed Answers >> Guaranteed Pass!!Current Update
What are the laparoscope diameters? 2-10mm
Which degree scope is best for a field in
0 degree
line with port?
Use anti fog solution or put scope in hot
How to prevent fogging of scope?
water/hot bath
What is the most commonly used light
300 W Xenon lamp
source?
What if there is initial low pressure and Leak in insufflator circuit, make sure
high flow rate at entry? everything plugged in correctly
Tissue is heated quickly, less thermal
Benefits of monopolar
damage/coagulation
Monopolar voltage/frequency Low voltage/High frequency
Repid surface heating with shallow depth
What does coagulation mode do? of necrosis, intermittent wave form with
higher voltage
Current can be diverted through uninten-
tional pathways, leading to inadvertent
Risk of monopolar
tissue injury. Don't use hybrid ports that
mix metal with plastic
Capacitative coupling - transfer of energy
between two conductors separated by an
Why do you need a grounding pad for insulator, transfer to passive electrode.
monopolar? Can release with tissue injury, but no
issue if ground plate is working as capac-
itor can't store the charge
lower energy, producing less lateral tis-
Benefits of bipolar sue damage and necrosis. Don't need a
grounding pad
Risk of cutting patient vessels before ad-
Risk of bipolar equate sealing, and device doesn't work
if there is metal between the jaws
Active blade can injure something due to
Risk of ultrasonic dissection (harmonic)
high frequency (50mHz)
Discontinue aspirin day of surgery? No
, FLS {Fundamentals of Laparoscopic Surgery} Verified Multiple Choice and Conceptual Actual Exam
Questions With Reviewed 100% Correct Detailed Answers >> Guaranteed Pass!!Current Update
How to enter in patient with bowel ob-
Direct visualization
struction?
cut - heat tissue quickly to convert cell
water to steam, lysing the cell
Cut vs Coag
Coag - heat more widely dispersed, less
cutting action
smaller tissue area, greater current den-
e.g. Bovie tip
sity and faster heating
- Low voltage
- High frequency
Cut mode - Continuous waveform
- Heats tissue quickly; cell water converts
to steam and causes cell to explode
- High voltage
- Low frequency
- Intermittent waveform
Coagulation mode - Rapid tissue heating, shallow depth of
necrosis
- Non-contact: relies on sparking to tis-
sue
Transfer current from active electrode
through insulation to passive electrode-
electrode to plastic part another LSC in-
Capacitive coupling
strument
- if constant contact w/ tissue will not
store energy and no injury
monopolar instrument in direct contact
Direct coupling
w/ metal portion of another instrument
Besides capacitative coupling and di-
- Current diversion
rect coupling, other hazards of electro-
- Narrow return circuit
cautery
- forceps w/ two twins (one active other
return)
Bipolar - no pt return electrode required)
- no capacitative coupling
- works in "wet" operative field
, FLS {Fundamentals of Laparoscopic Surgery} Verified Multiple Choice and Conceptual Actual Exam
Questions With Reviewed 100% Correct Detailed Answers >> Guaranteed Pass!!Current Update
- less thermal spread compared to
monopolar
bipolar seals vessels up to mm in
7 mm
diameter
ultrasonic coagulation shears seals ves-
5 mm
sels up to mm in diameter
- combo compression and friction
- ONE active blade
- monopolar capacity w/ the one blade
ultrasonic coagulation shears
- no capacitative coupling
- high power (MAX): cut
- low power (MIN): coag
How many days prior to surgery does
3 days
warfarin has to be discontinued?
ASA 2 Mild to moderate systemic disease
severe systemic disease that limits pa-
ASA 3 tient activity, may or may not be related
to reason for surgery
Severe systemic disturbances that limit
ASA 4 patient and are life-threatening with or
without surgery
Little change for survival but surgery last
ASA 5
resort (resuscitative effort)
ASA 4 and 5
ASA classes that may not be appropriate
- body cannot handle decreased venous
for LSC sx
return, need for hyperventilation
Length of trocar needed for obese pt >100 mm
- Inability to tolerate laparotomy
- Hypovolemic shock
ABSOLUTE C/I to LSC Sx - Lack proper surgeon training/experi-
ence
- Lack appropriate institutional support
- Inability to tolerate GETA
- Long-standing peritonitis
