FLS Fundamentals of Laparoscopic Surgery Verified Multiple Choice and Conceptual Actual Exam
Questions With Reviewed 100% Correct Detailed Answers >> Guaranteed Pass!!Current Update
St
Laproscopic instruments diameter and
2-10mm, 30-45cm
length ranges
light has to travel back through the rod to
hopkins rod lens
capture the image.
decreasing diameter, increasing scope
decreasing light in the camera for... angle (ie 5mm and 30 degree has less
light than 10mm 0 degree)
when working in a small area directly in
When is zero degree scope most useful line with the scope and ports, like the
pelvis
how to check fiber optics light connection black dots= broken fibers
temperature and humidity discrepancy
why does camera fog up?
between the OR and body
FRED antifog (let dry a few seconds be-
tools for defogging scope fore putting back in), put laparoscope in
hot water
gently wipe on clean tissue (liver, uterus,
methods to clean a smudged lens bowel), remove scope and clean with hot
water and gauze
CO2- readily available, inexpensive, non
Insufflation gas type and reasoning combustable, warmed and humidified
better
high flow insufflation 10 or more L per minute
preventing loss of pneumo with suction-
keep suction tip below the fluid level
ing
most common light source 300W xenon lamp
1. check that co2 tank is full
2. check co2 tank gasket is secured
Troubleshooting steps: gas preOP
3. check that spare co2 tank is available
in the OR
1. check that the monitor is plugged in
troubleshooting steps: image and turned on 2. check that all cables are
connected securely
troubleshooting steps: loss of working
space: insufflator settings: measured
pressure is the same or higher than the
,1. the patient may not be adequately re-
laxed or there is a mechanical block of
gas flow
2. inspect abdomen for rhythmic muscle
contraction and palpate the abdomen for
firmness
3. check port valves to make sure they
are open
4. check for kinks in tubing and make
sure no one is standing on them
1. there is a leak in the insufflation circuit
2. check that the tubing has not become
troubleshooting steps: loss of working disconnected from insufflator or port
space: insufflator settings: low pressure 3. check that all valves are closed
and high flow rate 4. check all port sites for leaking co2
5. check for foley catheter bag distention
or bowel distention
troubleshooting steps: loss of working 1. make sure that the insufflator power is
space: insufflator settings: low pressure on
and no flow 2. check gas level in the tank
1. check for disconnected power cords,
troubleshooting steps: loss of working video cables
space: complete loss of operative image 2. check for blown light source bulb
3. check for disconnected light cable
electrical surgical unit-->active elec-
trode-->patient tissue-->dispersive elec-
trode (grounding pad)
Monopolar electrosurgery curcuit
low frequency from wall source to high
frequency at active electrode
occurs as a result of tissue heating and
monopolar: tissue coagulation
protein denaturation.
tissue temp rises--->water is evaporat-
ed from the tissue--> increased imped-
monopolar: desiccation ance---> electricity stops flowing be-
cause of increased resistance-->tissue
turns brown, bubbles and steams.
, Hemostasis due to fibrous binding be-
tween dehydrated, denatured cells of
vessel endothelium
amount of current flowing through cross
sectional area.
directly proportional to power, inversely
related to tissue resistance
monopolar: current density
ie larger the area, less current density
appendiceal stump example - due to cur-
rent density risk of thermal injury beyond
ligature.
heat tissue quickly. cell water is con-
verted to steam, causing the cell to ex-
plode. minimal later thermal tissue dam-
monopolar: cut mode age, but poor thermal coagulation. un-
modulated waveform with low voltage.
electrode should not contact tissue di-
rectly.
rapid surface heating, shallow depth of
necrosis- fulguration. intermittent wave
with high voltage
monopolar: coag mode
significant cutting does not occur be-
cause heat is more widely dispersed
risk of current diversion. current follows
potential hazards of laparoscopic
path of least resistance and can pass
monopolar: current diversion
through unintentional tissue
transfer of current from an active elec-
trode through its insulation to a passive
potential hazards of laparoscopic electrode.
monopolar: capacitive coupling
active electrode (such as monopolar
hook) can give a charge if it touches a
Questions With Reviewed 100% Correct Detailed Answers >> Guaranteed Pass!!Current Update
St
Laproscopic instruments diameter and
2-10mm, 30-45cm
length ranges
light has to travel back through the rod to
hopkins rod lens
capture the image.
decreasing diameter, increasing scope
decreasing light in the camera for... angle (ie 5mm and 30 degree has less
light than 10mm 0 degree)
when working in a small area directly in
When is zero degree scope most useful line with the scope and ports, like the
pelvis
how to check fiber optics light connection black dots= broken fibers
temperature and humidity discrepancy
why does camera fog up?
between the OR and body
FRED antifog (let dry a few seconds be-
tools for defogging scope fore putting back in), put laparoscope in
hot water
gently wipe on clean tissue (liver, uterus,
methods to clean a smudged lens bowel), remove scope and clean with hot
water and gauze
CO2- readily available, inexpensive, non
Insufflation gas type and reasoning combustable, warmed and humidified
better
high flow insufflation 10 or more L per minute
preventing loss of pneumo with suction-
keep suction tip below the fluid level
ing
most common light source 300W xenon lamp
1. check that co2 tank is full
2. check co2 tank gasket is secured
Troubleshooting steps: gas preOP
3. check that spare co2 tank is available
in the OR
1. check that the monitor is plugged in
troubleshooting steps: image and turned on 2. check that all cables are
connected securely
troubleshooting steps: loss of working
space: insufflator settings: measured
pressure is the same or higher than the
,1. the patient may not be adequately re-
laxed or there is a mechanical block of
gas flow
2. inspect abdomen for rhythmic muscle
contraction and palpate the abdomen for
firmness
3. check port valves to make sure they
are open
4. check for kinks in tubing and make
sure no one is standing on them
1. there is a leak in the insufflation circuit
2. check that the tubing has not become
troubleshooting steps: loss of working disconnected from insufflator or port
space: insufflator settings: low pressure 3. check that all valves are closed
and high flow rate 4. check all port sites for leaking co2
5. check for foley catheter bag distention
or bowel distention
troubleshooting steps: loss of working 1. make sure that the insufflator power is
space: insufflator settings: low pressure on
and no flow 2. check gas level in the tank
1. check for disconnected power cords,
troubleshooting steps: loss of working video cables
space: complete loss of operative image 2. check for blown light source bulb
3. check for disconnected light cable
electrical surgical unit-->active elec-
trode-->patient tissue-->dispersive elec-
trode (grounding pad)
Monopolar electrosurgery curcuit
low frequency from wall source to high
frequency at active electrode
occurs as a result of tissue heating and
monopolar: tissue coagulation
protein denaturation.
tissue temp rises--->water is evaporat-
ed from the tissue--> increased imped-
monopolar: desiccation ance---> electricity stops flowing be-
cause of increased resistance-->tissue
turns brown, bubbles and steams.
, Hemostasis due to fibrous binding be-
tween dehydrated, denatured cells of
vessel endothelium
amount of current flowing through cross
sectional area.
directly proportional to power, inversely
related to tissue resistance
monopolar: current density
ie larger the area, less current density
appendiceal stump example - due to cur-
rent density risk of thermal injury beyond
ligature.
heat tissue quickly. cell water is con-
verted to steam, causing the cell to ex-
plode. minimal later thermal tissue dam-
monopolar: cut mode age, but poor thermal coagulation. un-
modulated waveform with low voltage.
electrode should not contact tissue di-
rectly.
rapid surface heating, shallow depth of
necrosis- fulguration. intermittent wave
with high voltage
monopolar: coag mode
significant cutting does not occur be-
cause heat is more widely dispersed
risk of current diversion. current follows
potential hazards of laparoscopic
path of least resistance and can pass
monopolar: current diversion
through unintentional tissue
transfer of current from an active elec-
trode through its insulation to a passive
potential hazards of laparoscopic electrode.
monopolar: capacitive coupling
active electrode (such as monopolar
hook) can give a charge if it touches a
