FLS Written Exam Study Guide Questions with
Detailed Answers UPDATED 2025
Which is the most commonly used trocar in laparoscopic surgery? -Correct Answer ✔The
Hasson trocar is commonly used to establish the first port in laparoscopic surgery,
particularly in patients with obesity or those who may be at risk for gas embolism.
What is the most common complication of laparoscopic surgery? -Correct Answer
✔Bowel perforation
Explanation: Bowel perforation is one of the most common complications during
laparoscopic surgery, often occurring during the insertion of the Veress needle or
trocars.
Why is CO2 used for insufflation? -Correct Answer ✔it is non-flammable (?) and can be
safely absorbed by the body
Is CO2 flammable? -Correct Answer ✔CO2 (Carbon Dioxide) is not flammable. It is
actually used in laparoscopic surgery precisely because it is non-flammable and can
safely create the pneumoperitoneum (inflated abdominal cavity) without posing a fire
hazard. In fact, CO2 is used to displace oxygen in the abdominal cavity, which helps
prevent fires from occurring.
The issue I was referencing with laser energy in the answer about fire hazards is related
to the fact that lasers can ignite fires when used near flammable gases or materials, but
CO2 itself is not flammable.
Complication of veress needle -Correct Answer ✔bowel injury
gas embolism
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What is the most common complication associated with trocar insertion? -Correct
Answer ✔Bowel perforation
In laparoscopic cholecystectomy, which of the following is a reliable method to identify
the cystic duct during dissection? -Correct Answer ✔The "critical view of safety"
technique
Explanation: This technique involves identifying the cystic duct and cystic artery
separately and fully dissecting around them to minimize the risk of bile duct injury.
During laparoscopic surgery, CO2 insufflation can lead to increased intra-abdominal
pressure.
Which of the following physiologic effects can occur as a result of increased intra-
abdominal pressure? -Correct Answer ✔Decreased venous return and reduced cardiac
output
Explanation: High intra-abdominal pressure can compress the inferior vena cava,
reducing venous return to the heart and, consequently, cardiac output.
Which complication is most commonly associated with high insufflation pressures (>20
mmHg) in laparoscopic surgery? -Correct Answer ✔Abdominal compartment syndrome
Explanation: Elevated insufflation pressures can cause compartment syndrome, which
leads to increased intra-abdominal pressure and impairment of organ function.
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