FLS Modules Latest Update 2025-2026 Actual
Exam 360 Questions with 100% Verified Correct
Answers with Guaranteed A+ Verified by
Professor
absolute contraindications to blind veress needle insertion points - CORRECT
ANSWER: 1. insertion into abdominal scar from prior open operation
2. through previously placed intraperitoneal mesh for hernia repair
allen stirrups - CORRECT ANSWER: better than candy cane as they have better
individualization, especially in longer procedures
alternative gases: Argon and Helium - CORRECT ANSWER: eliminate the complication
of acidosis, but are much less soluble in blood. Decreased solubility increases the risk
of extra-peritoneal gas extravasation (gas embolus)
Alternative gases: NO - CORRECT ANSWER: benefits: less acid-base disturbance,
increased patient tolerability in patients with severe cardio pulmonary disease, less post
op pain
risks: fire hazard with electrocautery, cannot be used with suspected bowel perf
anterior abdominal wall dx lap - CORRECT ANSWER: to look for post op bleeding,
adhesions, hernia or tumor. use angled scope.
ASA level not appropriate for lap surgery - CORRECT ANSWER: 4-5, might not be able
to tolerate pneumoperitoneum due to decreased venous return and need for
hyperventilation
benefits of braided suture - CORRECT ANSWER: easier to handle, lack elastic
memory, don't fray
,biopsy forceps - CORRECT ANSWER: for incisional or excisional, or peritoneal
implants.
biopsy methods and what to avoid - CORRECT ANSWER: 1. peritoneal washings
2. FNA
3. Core needle
4. incisional (wedge)
5. excisional
avoid electrocautery
biopsy of visceral lesions - CORRECT ANSWER: if small and superficial can excise,
use serosal stitch to avoid leakage
bipolar definition - CORRECT ANSWER: tissue is placed between two electrodes.
current flows only through the tissue contiguous with both electrodes. lower energy
requirement, less lateral tissue damage.
Can seal vessels up to 7mm
bipolar energy delivery - CORRECT ANSWER: computer measures tissue impedance
of grasped tissue--.controlled energy delivery--> denaturation of collagen-->creation of
permanent seal
bipolar hazards: improper functioning if metal is within the jaws - CORRECT ANSWER:
including clips or staples
bipolar hazards: inadvertent cutting of vessels before adequate sealing - CORRECT
ANSWER: make sure to complete entire activation cycle prior to cutting
,bipolar hazards: inadvertent thermal injury - CORRECT ANSWER: avoid activating the
device in close proximity to adjacent organs
cardiac arrhythmia due to pneumoperitoneum (3) - CORRECT ANSWER: 1. sinus tach
(most common, self limited)
2. PVCs
3. bradycardia (due to pressure effect, vagally mediated)
cardiovascular effects of pneumo - CORRECT ANSWER: 1. increased preload
2. increased afterload
3. decreased CO
choice of staple height - CORRECT ANSWER: 1. vascular: 2-2.5mm
2. GI tract 3-3.5 mm
3. distal stomach or thickened GI tract 4-4.5 mm
CO2 chemical effects - CORRECT ANSWER: 1. increases arterial co2 concentration-->
drop in serum pH
2. increases end tidal co2 (greatest change In the first 20 minutes)
complications of veress needle insertion (8) - CORRECT ANSWER: 1. bowel injury
2. mesenteric or omental vascular injury
3. retroperitoneal vascular injury
4. cardiac arrhythmia
5. hypotension
6. high airway pressures
7. pneumothorax
, 8. gas embolism
contraindications to laparoscopy: absolute (4) - CORRECT ANSWER: 1. inability to
tolerate laparotomy
2. hypovolemic shock
3. lack of proper surgical training
4. lack of appropriate institutional support
contraindications to laparoscopy: relative (5) - CORRECT ANSWER: 1. inability to
tolerate general anesthesia
2. long standing peritonitis (can increase risk of injury on trocar insertion)
3. large abdominal or pelvic mass
4. massive incarcerated ventral and inguinal hernias (can have loss or peritoneal space)
5. severe cardiopulmonary disease (intolerance to proper positioning)
R/B ratio dictates
core needle biopsy - CORRECT ANSWER: most commonly used for liver biopsy but
should not be used for vascular lesions like hemangioma. 14-18gauge needle. more risk
for bleeding compared to FNA
decrease in CO - CORRECT ANSWER: Exacerbated by reverse trendelenburg and
hypovolemia. may be caused by vagally induced bradycardia
decreasing light in the camera for... - CORRECT ANSWER: decreasing diameter,
increasing scope angle (ie 5mm and 30 degree has less light than 10mm 0 degree)
desired intraabdominal pressure and how much co2 - CORRECT ANSWER: 10-15
mmHg
Exam 360 Questions with 100% Verified Correct
Answers with Guaranteed A+ Verified by
Professor
absolute contraindications to blind veress needle insertion points - CORRECT
ANSWER: 1. insertion into abdominal scar from prior open operation
2. through previously placed intraperitoneal mesh for hernia repair
allen stirrups - CORRECT ANSWER: better than candy cane as they have better
individualization, especially in longer procedures
alternative gases: Argon and Helium - CORRECT ANSWER: eliminate the complication
of acidosis, but are much less soluble in blood. Decreased solubility increases the risk
of extra-peritoneal gas extravasation (gas embolus)
Alternative gases: NO - CORRECT ANSWER: benefits: less acid-base disturbance,
increased patient tolerability in patients with severe cardio pulmonary disease, less post
op pain
risks: fire hazard with electrocautery, cannot be used with suspected bowel perf
anterior abdominal wall dx lap - CORRECT ANSWER: to look for post op bleeding,
adhesions, hernia or tumor. use angled scope.
ASA level not appropriate for lap surgery - CORRECT ANSWER: 4-5, might not be able
to tolerate pneumoperitoneum due to decreased venous return and need for
hyperventilation
benefits of braided suture - CORRECT ANSWER: easier to handle, lack elastic
memory, don't fray
,biopsy forceps - CORRECT ANSWER: for incisional or excisional, or peritoneal
implants.
biopsy methods and what to avoid - CORRECT ANSWER: 1. peritoneal washings
2. FNA
3. Core needle
4. incisional (wedge)
5. excisional
avoid electrocautery
biopsy of visceral lesions - CORRECT ANSWER: if small and superficial can excise,
use serosal stitch to avoid leakage
bipolar definition - CORRECT ANSWER: tissue is placed between two electrodes.
current flows only through the tissue contiguous with both electrodes. lower energy
requirement, less lateral tissue damage.
Can seal vessels up to 7mm
bipolar energy delivery - CORRECT ANSWER: computer measures tissue impedance
of grasped tissue--.controlled energy delivery--> denaturation of collagen-->creation of
permanent seal
bipolar hazards: improper functioning if metal is within the jaws - CORRECT ANSWER:
including clips or staples
bipolar hazards: inadvertent cutting of vessels before adequate sealing - CORRECT
ANSWER: make sure to complete entire activation cycle prior to cutting
,bipolar hazards: inadvertent thermal injury - CORRECT ANSWER: avoid activating the
device in close proximity to adjacent organs
cardiac arrhythmia due to pneumoperitoneum (3) - CORRECT ANSWER: 1. sinus tach
(most common, self limited)
2. PVCs
3. bradycardia (due to pressure effect, vagally mediated)
cardiovascular effects of pneumo - CORRECT ANSWER: 1. increased preload
2. increased afterload
3. decreased CO
choice of staple height - CORRECT ANSWER: 1. vascular: 2-2.5mm
2. GI tract 3-3.5 mm
3. distal stomach or thickened GI tract 4-4.5 mm
CO2 chemical effects - CORRECT ANSWER: 1. increases arterial co2 concentration-->
drop in serum pH
2. increases end tidal co2 (greatest change In the first 20 minutes)
complications of veress needle insertion (8) - CORRECT ANSWER: 1. bowel injury
2. mesenteric or omental vascular injury
3. retroperitoneal vascular injury
4. cardiac arrhythmia
5. hypotension
6. high airway pressures
7. pneumothorax
, 8. gas embolism
contraindications to laparoscopy: absolute (4) - CORRECT ANSWER: 1. inability to
tolerate laparotomy
2. hypovolemic shock
3. lack of proper surgical training
4. lack of appropriate institutional support
contraindications to laparoscopy: relative (5) - CORRECT ANSWER: 1. inability to
tolerate general anesthesia
2. long standing peritonitis (can increase risk of injury on trocar insertion)
3. large abdominal or pelvic mass
4. massive incarcerated ventral and inguinal hernias (can have loss or peritoneal space)
5. severe cardiopulmonary disease (intolerance to proper positioning)
R/B ratio dictates
core needle biopsy - CORRECT ANSWER: most commonly used for liver biopsy but
should not be used for vascular lesions like hemangioma. 14-18gauge needle. more risk
for bleeding compared to FNA
decrease in CO - CORRECT ANSWER: Exacerbated by reverse trendelenburg and
hypovolemia. may be caused by vagally induced bradycardia
decreasing light in the camera for... - CORRECT ANSWER: decreasing diameter,
increasing scope angle (ie 5mm and 30 degree has less light than 10mm 0 degree)
desired intraabdominal pressure and how much co2 - CORRECT ANSWER: 10-15
mmHg
