FLS EXAM QUESTIONS WITH 100%
CORRECT ANSWERS
In what age group port sites 5mm or smaller require closure of the fascia? - Answer-
Pediatric
Abdominal wall closure of the port sites can be accomplished using... - Answer-Open
techniques
Laparoscopic-assisted techniques
Entirely laparoscopic techniques
When should a check for venous bleeding be performed? - Answer-During final
abdominal inspection, while releasing abdominal pressure, and during trocar removal
Once the operative procedure is finished, the surgeon should check which areas before
exiting the abdomen? - Answer-Operative field, dependent portions of the abdomen
away from the field of view at the operative site, abdominal wall at each port site onece
the port has been removed
what is the correct patient position for diagnostic laparoscopy for pelvic procedure? -
Answer-dorsal lithotomy
what is the correct patient position for diagnostic laparoscopy for appendectomy? -
Answer-trendelenburg
which of the following pathology can be diagnosed laparoscopically? - Answer-Crohns,
traumatic diaphragm injury, and ovarian cyst
what are of the abomden is best for placement of ports to view kidneys and adrenal
glands? - Answer-Upper abdomen (epigastric, RUQ, LUQ)
retraction of the uterus can be accomplished by? - Answer-transvaginal manipulator,
blunt grasper, laparoscopic retractor, and suture placed through abdominal wall
In general, if an ovarian cyst is larger than 5cm or has complex internal US findings,
biopsy should be done by? - Answer-oophorectomy
general principles of successful laparoscopic tissue biopsy include all of the following
EXCEPT: - Answer-remove biopsy specimen with an energy source to avoid bleeding
,(correct answers include avoid contacting tissue of extraction site with specimen,
excisions biopsy of small lesions is appropriately, generally avoid biopsy of fluid filled
liver lesions)
which of the following about intracorporeal suturing is not true? - Answer-grasping the
needle is the ideal way to control it when transporting the suture in and out of the
abdomen
true statements include: the ideal suture length is about 6inches, the ideal orientation for
suturing is from 3 o'clock to 9 o'clock, pulling the needling along its arc through the
tissue will minimize damage
general principles regarding hemostasis during laparoscopy include all of the following
EXCEPT: - Answer-applying vascular clips to the general area is usually sufficient
correct statements include: it is best to specifically identify the bleeding point, avoiding
injury to adjacent structures is important, adding extra ports may be necessary,
conversion to open may be necessary
all of the following are generally true regarding port site bleeding EXCEPT - Answer-
there is no need to remove ports under direct visualization
correct answers include: external hemorrhage may require extension of skin incision,
internal hemorrhage may not be present while port is in place, internal hemorrhage may
not be visible from skin incision, ports placed through the rectus muscle should be done
under direct laparoscopic visualization
when compared to monopoly cautery, bipolar cautery affords all of the following
advantages EXCEPT - Answer-more beneficial for capillary sized vessels
correct answers include: useful for larger vessels, functions better in "wet" operative
field, has advanced computer devices available,e has less lateral thermal spread
when dividing a large vascular structure, which of the following is true? - Answer-the
surgeon must be prepared to immediately intervene in case vascular control is lost
for how many days postoperatively will shoulder pain secondary to diaphragmatic
irritation typically persist? - Answer-1-3 days
which of the following classes of medications should NOT be considered to treat a
patient with postoperative nausea and vomiting? - Answer-morphine sulfate
correct answers include antihistamines, serotonin receptor antagonists, and
corticosteroids
, a patient in the early postoperative period following laparoscopic surgery who complains
of several days of increasing pain should be managed by? - Answer-instructing the
patient that he/she needs to be evaluated to determine the cause of the increasing pain
Peumoperitoneum should be? - Answer-10-15mmHg = 1-3L CO2
Relative contraindications to Blind initial trocar insertion - Answer-Previous abdominal
surgery
Previous intra-abdominal inflammatory process
Absolute contraindications to Blind initial trocar insertion - Answer-Abdominal scar from
prior open operation in immediate vicinity of trocar insertion
Through previously placed intraperitoneal mesh for hernia repair
Types of trocar tips - Answer-Knife blade tip
Plastic tip
Protective spring loaded shield
Optical tip
Complications of Veress Needle insertion - Answer-Bowel injury
Mesenteric or omental vascular injury
Retroperitoneal vascular injury
Cardiac arrhythmia
Hypotension
High airway pressures
Pneumothorax (w/initial gas insufflation)
Gas embolism (w/initial gas insufflation)
Why additional (secondary) trocars should not be placed in the middle of the rectus
muscles? - Answer-To avoid injury to the inferior epigastric vessels (cannot be seen
with translumination of the abdominal wall
When checking placement of the Veress needle, which is the most accurate method to
detect proper intraperitoneal placement? - Answer-Insufflator display revealing flow of
CO2 and low initial pressure
Monitoring during pneumoperitoneum - Answer-Cardiac rhythm
Pulse oximetry
End tidial CO2
HR
Blood pressure
Urine output
Upper Abdominal Laparoscopy - Position and equipment - Answer-Arms can be out on
arm boards
Reverse Trendelenberg position (need foot board and leg strap)
CORRECT ANSWERS
In what age group port sites 5mm or smaller require closure of the fascia? - Answer-
Pediatric
Abdominal wall closure of the port sites can be accomplished using... - Answer-Open
techniques
Laparoscopic-assisted techniques
Entirely laparoscopic techniques
When should a check for venous bleeding be performed? - Answer-During final
abdominal inspection, while releasing abdominal pressure, and during trocar removal
Once the operative procedure is finished, the surgeon should check which areas before
exiting the abdomen? - Answer-Operative field, dependent portions of the abdomen
away from the field of view at the operative site, abdominal wall at each port site onece
the port has been removed
what is the correct patient position for diagnostic laparoscopy for pelvic procedure? -
Answer-dorsal lithotomy
what is the correct patient position for diagnostic laparoscopy for appendectomy? -
Answer-trendelenburg
which of the following pathology can be diagnosed laparoscopically? - Answer-Crohns,
traumatic diaphragm injury, and ovarian cyst
what are of the abomden is best for placement of ports to view kidneys and adrenal
glands? - Answer-Upper abdomen (epigastric, RUQ, LUQ)
retraction of the uterus can be accomplished by? - Answer-transvaginal manipulator,
blunt grasper, laparoscopic retractor, and suture placed through abdominal wall
In general, if an ovarian cyst is larger than 5cm or has complex internal US findings,
biopsy should be done by? - Answer-oophorectomy
general principles of successful laparoscopic tissue biopsy include all of the following
EXCEPT: - Answer-remove biopsy specimen with an energy source to avoid bleeding
,(correct answers include avoid contacting tissue of extraction site with specimen,
excisions biopsy of small lesions is appropriately, generally avoid biopsy of fluid filled
liver lesions)
which of the following about intracorporeal suturing is not true? - Answer-grasping the
needle is the ideal way to control it when transporting the suture in and out of the
abdomen
true statements include: the ideal suture length is about 6inches, the ideal orientation for
suturing is from 3 o'clock to 9 o'clock, pulling the needling along its arc through the
tissue will minimize damage
general principles regarding hemostasis during laparoscopy include all of the following
EXCEPT: - Answer-applying vascular clips to the general area is usually sufficient
correct statements include: it is best to specifically identify the bleeding point, avoiding
injury to adjacent structures is important, adding extra ports may be necessary,
conversion to open may be necessary
all of the following are generally true regarding port site bleeding EXCEPT - Answer-
there is no need to remove ports under direct visualization
correct answers include: external hemorrhage may require extension of skin incision,
internal hemorrhage may not be present while port is in place, internal hemorrhage may
not be visible from skin incision, ports placed through the rectus muscle should be done
under direct laparoscopic visualization
when compared to monopoly cautery, bipolar cautery affords all of the following
advantages EXCEPT - Answer-more beneficial for capillary sized vessels
correct answers include: useful for larger vessels, functions better in "wet" operative
field, has advanced computer devices available,e has less lateral thermal spread
when dividing a large vascular structure, which of the following is true? - Answer-the
surgeon must be prepared to immediately intervene in case vascular control is lost
for how many days postoperatively will shoulder pain secondary to diaphragmatic
irritation typically persist? - Answer-1-3 days
which of the following classes of medications should NOT be considered to treat a
patient with postoperative nausea and vomiting? - Answer-morphine sulfate
correct answers include antihistamines, serotonin receptor antagonists, and
corticosteroids
, a patient in the early postoperative period following laparoscopic surgery who complains
of several days of increasing pain should be managed by? - Answer-instructing the
patient that he/she needs to be evaluated to determine the cause of the increasing pain
Peumoperitoneum should be? - Answer-10-15mmHg = 1-3L CO2
Relative contraindications to Blind initial trocar insertion - Answer-Previous abdominal
surgery
Previous intra-abdominal inflammatory process
Absolute contraindications to Blind initial trocar insertion - Answer-Abdominal scar from
prior open operation in immediate vicinity of trocar insertion
Through previously placed intraperitoneal mesh for hernia repair
Types of trocar tips - Answer-Knife blade tip
Plastic tip
Protective spring loaded shield
Optical tip
Complications of Veress Needle insertion - Answer-Bowel injury
Mesenteric or omental vascular injury
Retroperitoneal vascular injury
Cardiac arrhythmia
Hypotension
High airway pressures
Pneumothorax (w/initial gas insufflation)
Gas embolism (w/initial gas insufflation)
Why additional (secondary) trocars should not be placed in the middle of the rectus
muscles? - Answer-To avoid injury to the inferior epigastric vessels (cannot be seen
with translumination of the abdominal wall
When checking placement of the Veress needle, which is the most accurate method to
detect proper intraperitoneal placement? - Answer-Insufflator display revealing flow of
CO2 and low initial pressure
Monitoring during pneumoperitoneum - Answer-Cardiac rhythm
Pulse oximetry
End tidial CO2
HR
Blood pressure
Urine output
Upper Abdominal Laparoscopy - Position and equipment - Answer-Arms can be out on
arm boards
Reverse Trendelenberg position (need foot board and leg strap)
