FLS COMPREHENSIVE EXAM UPDATED QUESTIONS AND
ANSWERS GRADED A+
✔✔3-3.5 mm staples - ✔✔- blue
- for majority GI tract
✔✔4-4.5 mm staples - ✔✔- green
- for distal stomach, thickened portions of GI tract
✔✔Monopolar cautery - ✔✔- smaller vessels, slow rate bleeding, need relatively dry
operative field
✔✔Days until full diet tolerated - ✔✔1-2d for fundoplication
3-6d for colon resection
✔✔Postop - vascular injury smaller vessels - ✔✔- usu superior/inferior epigastric
vessels, mesenteric arteries/veins
--> abd wall or peritoneal hematomas.
- Surgery if con't bleeding, infxn, HD instability
✔✔In the event of a blank screen, which is NOT a likely problem site? - ✔✔FRED anti-
fog solution
✔✔If the laparoscopic view of the operative field is reduced in size, thus compromising
proper exposure of the operative field, which of the following should be immediately
checked? - ✔✔check the insufflator control panel to determine the cause of the loss of
working space in the operative field
✔✔all of the following are pre-operative checks except? - ✔✔check for adequate
muscle relaxation. Correct answers include checking that a spare CO2 tank is in the
OR, availability of ancillary equipment, and all power sources are connected and
appropriate units are switched on
✔✔During monopolar electrosurgery, the method of heating tissue quickly, converting
all water to steam and causing the cell to explode is descriptive of which of the
following: - ✔✔cutting mode
✔✔click on the point that is in danger of thermal burn if a monopolar electrode is applied
to the end of the appendiceal stump? - ✔✔the diameter at the ligature is half that at the
stump, so the current density will be 16X greater
✔✔the use of all plastic or all metal trocars can avoid which problem during
electrosurgery? - ✔✔capacitative coupling is a result of using a metal tracer with a
, plastic screw anchor, which prevents the tracer from draining its charge (instrument can
store the charge and then transmit to tissue next time it touches something)
✔✔when using the ultrasonic shears, the entire portion of the active blade is exposed.
In order to avoid inadvertent delivery of energy to tissue in contact with the bottom
portion of the active blade, one should do the following: - ✔✔be aware of the contact
points the blade is engaging, grab the target tissue and elevate it, and keep the active
blade upwards in view of the surgeon
✔✔ASA class 3 - ✔✔severe systemic disease that limits the patient's activity and may
or may not be related to the reason for surgery
✔✔initial consultation should include which of the following? - ✔✔possibility of
conversion to open surgery
✔✔which of the following is a relative contraindication to laparoscopic surgery? -
✔✔previous abdominal surgery
✔✔which of these is NOT an absolute contraindication to laparoscopic surgery? -
✔✔bowel obstruction (contraindications include uncorrectable hypovolemic shock, lack
of proper surgical training, and inability to tolerate laparotomy)
✔✔which procedure may be performed using local anesthesia alone or with mild
sedation? - ✔✔diagnostic laparoscopy
✔✔important features in patient positioning for laparoscopic surgery include: -
✔✔avoidance of position related complications, prevention of DVT, and location of
target organ
✔✔the most commonly used anesthetic for laparoscopic procedures is general
anesthesia. all of the following are true EXCEPT - ✔✔there are fewer hemodynamic
changes compared to a local anesthetic (true answers are it allows for complete
neuromuscular relaxation, it provides good control of ventilation, an tit allows for more
flexibility of patient positioning)
✔✔what is the most common site for initial trocar insertion? - ✔✔umbilicus
✔✔When checking placement of Veress needle, which of the following is the most
accurate method to detect proper intraperitoneal placement? - ✔✔insufflator display
revealing flow of CO2 and low initial pressure
✔✔umbilical Veress needle insertion and blind tracer insertion is contraindicated in all of
the following EXCEPT? - ✔✔previous open cholecystectomy via right subcostal incision
ANSWERS GRADED A+
✔✔3-3.5 mm staples - ✔✔- blue
- for majority GI tract
✔✔4-4.5 mm staples - ✔✔- green
- for distal stomach, thickened portions of GI tract
✔✔Monopolar cautery - ✔✔- smaller vessels, slow rate bleeding, need relatively dry
operative field
✔✔Days until full diet tolerated - ✔✔1-2d for fundoplication
3-6d for colon resection
✔✔Postop - vascular injury smaller vessels - ✔✔- usu superior/inferior epigastric
vessels, mesenteric arteries/veins
--> abd wall or peritoneal hematomas.
- Surgery if con't bleeding, infxn, HD instability
✔✔In the event of a blank screen, which is NOT a likely problem site? - ✔✔FRED anti-
fog solution
✔✔If the laparoscopic view of the operative field is reduced in size, thus compromising
proper exposure of the operative field, which of the following should be immediately
checked? - ✔✔check the insufflator control panel to determine the cause of the loss of
working space in the operative field
✔✔all of the following are pre-operative checks except? - ✔✔check for adequate
muscle relaxation. Correct answers include checking that a spare CO2 tank is in the
OR, availability of ancillary equipment, and all power sources are connected and
appropriate units are switched on
✔✔During monopolar electrosurgery, the method of heating tissue quickly, converting
all water to steam and causing the cell to explode is descriptive of which of the
following: - ✔✔cutting mode
✔✔click on the point that is in danger of thermal burn if a monopolar electrode is applied
to the end of the appendiceal stump? - ✔✔the diameter at the ligature is half that at the
stump, so the current density will be 16X greater
✔✔the use of all plastic or all metal trocars can avoid which problem during
electrosurgery? - ✔✔capacitative coupling is a result of using a metal tracer with a
, plastic screw anchor, which prevents the tracer from draining its charge (instrument can
store the charge and then transmit to tissue next time it touches something)
✔✔when using the ultrasonic shears, the entire portion of the active blade is exposed.
In order to avoid inadvertent delivery of energy to tissue in contact with the bottom
portion of the active blade, one should do the following: - ✔✔be aware of the contact
points the blade is engaging, grab the target tissue and elevate it, and keep the active
blade upwards in view of the surgeon
✔✔ASA class 3 - ✔✔severe systemic disease that limits the patient's activity and may
or may not be related to the reason for surgery
✔✔initial consultation should include which of the following? - ✔✔possibility of
conversion to open surgery
✔✔which of the following is a relative contraindication to laparoscopic surgery? -
✔✔previous abdominal surgery
✔✔which of these is NOT an absolute contraindication to laparoscopic surgery? -
✔✔bowel obstruction (contraindications include uncorrectable hypovolemic shock, lack
of proper surgical training, and inability to tolerate laparotomy)
✔✔which procedure may be performed using local anesthesia alone or with mild
sedation? - ✔✔diagnostic laparoscopy
✔✔important features in patient positioning for laparoscopic surgery include: -
✔✔avoidance of position related complications, prevention of DVT, and location of
target organ
✔✔the most commonly used anesthetic for laparoscopic procedures is general
anesthesia. all of the following are true EXCEPT - ✔✔there are fewer hemodynamic
changes compared to a local anesthetic (true answers are it allows for complete
neuromuscular relaxation, it provides good control of ventilation, an tit allows for more
flexibility of patient positioning)
✔✔what is the most common site for initial trocar insertion? - ✔✔umbilicus
✔✔When checking placement of Veress needle, which of the following is the most
accurate method to detect proper intraperitoneal placement? - ✔✔insufflator display
revealing flow of CO2 and low initial pressure
✔✔umbilical Veress needle insertion and blind tracer insertion is contraindicated in all of
the following EXCEPT? - ✔✔previous open cholecystectomy via right subcostal incision
