FUNDAMENTALS OF LAPAROSCOPIC
SURGERY EXAM
ALL QUESTIONS AND CORRECT
ANSWERS
GRADED A+ | LATEST EXAM | VERIFIED
ANSWERS
Describe a monopolar energy route? ANSWER: -electrode > tissue > patient >
return pad
Describe a bipolar energy route? ANSWER: -electrode > tissue > electrode
--> Electrodes shaped like forceps
Name three modes of monopolar devices?
ANSWER: -cut
-coagulation
-blending
Describe the mechanism of monopolar cutting? ANSWER: -heats tissue quickly >
converts water to steam > causes cells to explode
Describe the mechanism of monopolar coagulation? ANSWER: -rapid surface
heating
1|Page
,What is current diversion and when does it occur? ANSWER: -when current
passes through unintentional tissue following the path of least resistance
What precautions should surgeons take when utilizing laparoscopy?
ANSWER: -inspect insulation carefully
-use lowest possible power setting
-use lowest voltage waveform possible
-use brief intermittent activation vs. prolonged activation
-do not active unless in close proximity to target tissue
-do not activate in close proximity to another instrument
-use bipolar instrumentation when possible
What is capacitative coupling? ANSWER: -the transfer of energy within an
electrical network or between distant networks by means of displacement current
between circuit nodes, induced by the electric field
What is direct coupling? ANSWER: -the the transfer of electrical energy by means
of physical contact via a conductive medium (such as between two instruments)
When is a narrow return circuit formed? ANSWER: -when a monopolar instrument
comes into contact with a ligated tissue
Bipolar instruments can seal vessels up to what diameter? ANSWER: -7 mm
2|Page
,What are Hazards of using bipolar instruments?
ANSWER: -inadvertent thermal injury
-inadvertent cutting of patent before adequate sealing
-improper device function if metal is contained within the jaws
The harmonic is an example of what type of device? ANSWER: -piezoelectric
transducer
The use of all plastic or all metal trocars can avoid which problem during
electrosurgery? ANSWER: -capacitative coupling
Surgeons should have their arms how many degrees away from their body?
ANSWER: -30 degrees
Elbows should be flexed between...? ANSWER: -60 to 120 degrees
When should warfarin be discontinued before surgery? ANSWER: -three days
Any proof that NSAIDs need to be discontinued before surgery? ANSWER: -no
ASA class one? ANSWER: -no disturbance
ASA class two? ANSWER: -mild to moderate systemic disease
ASA class three? ANSWER: -severe systemic disease
3|Page
, What patients may not be suitable for LSC surgery? ANSWER: -ASA 4 and 5
How long should trocars be in obsese patients? ANSWER: -greater than 100 mm
Approaches to minimizing complications during entry in thin patients?
ANSWER: -elevating abdominal wall
-place veress near costal margin
-use hassan open approach or direct entry
Absolute contraindications to laparoscopy?
ANSWER: -hypovolemic shock
-lack of training
-lack of institutional support
-can't tolerate laparotomy
Relative contraindications to laparoscopy?
ANSWER: -inability to tolerate general anesthesia
-long-standing peritonitis
-large abdominal or pelvic mass
-massive incarcerated ventral and inguinal hernias
-severe cardiopulmonary disease
4|Page
SURGERY EXAM
ALL QUESTIONS AND CORRECT
ANSWERS
GRADED A+ | LATEST EXAM | VERIFIED
ANSWERS
Describe a monopolar energy route? ANSWER: -electrode > tissue > patient >
return pad
Describe a bipolar energy route? ANSWER: -electrode > tissue > electrode
--> Electrodes shaped like forceps
Name three modes of monopolar devices?
ANSWER: -cut
-coagulation
-blending
Describe the mechanism of monopolar cutting? ANSWER: -heats tissue quickly >
converts water to steam > causes cells to explode
Describe the mechanism of monopolar coagulation? ANSWER: -rapid surface
heating
1|Page
,What is current diversion and when does it occur? ANSWER: -when current
passes through unintentional tissue following the path of least resistance
What precautions should surgeons take when utilizing laparoscopy?
ANSWER: -inspect insulation carefully
-use lowest possible power setting
-use lowest voltage waveform possible
-use brief intermittent activation vs. prolonged activation
-do not active unless in close proximity to target tissue
-do not activate in close proximity to another instrument
-use bipolar instrumentation when possible
What is capacitative coupling? ANSWER: -the transfer of energy within an
electrical network or between distant networks by means of displacement current
between circuit nodes, induced by the electric field
What is direct coupling? ANSWER: -the the transfer of electrical energy by means
of physical contact via a conductive medium (such as between two instruments)
When is a narrow return circuit formed? ANSWER: -when a monopolar instrument
comes into contact with a ligated tissue
Bipolar instruments can seal vessels up to what diameter? ANSWER: -7 mm
2|Page
,What are Hazards of using bipolar instruments?
ANSWER: -inadvertent thermal injury
-inadvertent cutting of patent before adequate sealing
-improper device function if metal is contained within the jaws
The harmonic is an example of what type of device? ANSWER: -piezoelectric
transducer
The use of all plastic or all metal trocars can avoid which problem during
electrosurgery? ANSWER: -capacitative coupling
Surgeons should have their arms how many degrees away from their body?
ANSWER: -30 degrees
Elbows should be flexed between...? ANSWER: -60 to 120 degrees
When should warfarin be discontinued before surgery? ANSWER: -three days
Any proof that NSAIDs need to be discontinued before surgery? ANSWER: -no
ASA class one? ANSWER: -no disturbance
ASA class two? ANSWER: -mild to moderate systemic disease
ASA class three? ANSWER: -severe systemic disease
3|Page
, What patients may not be suitable for LSC surgery? ANSWER: -ASA 4 and 5
How long should trocars be in obsese patients? ANSWER: -greater than 100 mm
Approaches to minimizing complications during entry in thin patients?
ANSWER: -elevating abdominal wall
-place veress near costal margin
-use hassan open approach or direct entry
Absolute contraindications to laparoscopy?
ANSWER: -hypovolemic shock
-lack of training
-lack of institutional support
-can't tolerate laparotomy
Relative contraindications to laparoscopy?
ANSWER: -inability to tolerate general anesthesia
-long-standing peritonitis
-large abdominal or pelvic mass
-massive incarcerated ventral and inguinal hernias
-severe cardiopulmonary disease
4|Page
