FLS MODULES QUESTIONS AND ANSWERS
Laproscopic instruments diameter and length ranges - Answer -2-10mm, 30-45cm
Hopkins rod lens - Answer -light has to travel back through the rod to capture the
image.
Decreasing light in the camera for... - Answer -decreasing diameter, increasing scope
angle (ie 5mm and 30 degree has less light than 10mm 0 degree)
When is zero degree scope most useful - Answer -when working in a small area
directly in line with the scope and ports, like the pelvis
How to check fiber optics light connection - Answer -black dots= broken fibers
Why does it fog up? - Answer -temperature and humidity discrepancy between the OR
and body
Tools for defogging - Answer -FRED antifog (must dry before putting back in), put
laparoscope in hot water
Methods to clean a smudged lens - Answer -gently wipe on clean tissue (liver, uterus,
bowel), remove scope and clean with hot water and gauze
Insufflation gas type and reasoning - Answer -CO2- readily available, inexpensive, non
combustable, warmed and humidified better
High flow insufflation - Answer -10 or more L per minute
Preventing loss of pneumo with suctioning - Answer -keep suction tip below the fluid
level
Most common light source - Answer -300W xenon lamp
Troubleshooting steps: gas preop - Answer -1. Check that co2 tank is full
2. Check co2 tank gasket is secured
3. Check that spare co2 tank is available in the OR
Troubleshooting steps: image - Answer -1. Check that the monitor is plugged in and
turned on 2. Check that all cables are connected securely
Troubleshooting steps: loss of working space: insufflator settings: measured pressure is
the same or higher than the preset pressure - Answer -1. The patient may not be
adequately relaxed or there is a mechanical block of gas flow
, 2. Inspect abdomen for rhythmic muscle contraction and palpate the abdomen for
firmness
3. Check port valves to make sure they are open
4. Check for kinks in tubing and make sure no one is standing on them
Troubleshooting steps: loss of working space: insufflator settings: low pressure and high
flow rate - Answer -1. There is a leak in the insufflation circuit
2. Check that the tubing has not become disconnected from insufflator or port
3. Check that all valves are closed
4. Check all port sites for leaking co2
5. Check for foley catheter bag distention or bowel distention
Troubleshooting steps: loss of working space: insufflator settings: low pressure and no
flow - Answer -1. Make sure that the insufflator power is on
2. Check gas level in the tank
Troubleshooting steps: loss of working space: complete loss of operative image -
Answer -1. Check for disconnected power cords, video cables
2. Check for blown light source bulb
3. Check for disconnected light cable
Monopolar electrosurgery curcuit - Answer -electrical surgical unit-->active electrode--
>patient tissue-->dispersive electrode (grounding pad)
Low frequency from wall source to high frequency at active electrode
Monopolar: tissue coagulation - Answer -occurs as a result of tissue heating and
protein denaturation.
Monopolar: desiccation - Answer -tissue temp rises--->water is evaporated from the
tissue--> increased impedance---> electricity stops flowing because of increased
resistance-->tissue turns brown, bubbles and steams.
Hemostasis due to fibrous binding between dehydrated, denatured cells of vessel
endothelium
Monopolar: current density - Answer -amount of current flowing through cross sectional
area.
Directly proportional to power, inversely related to tissue resistance
Ie larger the area, less current density
Monopolar: cut mode - Answer -heat tissue quickly. Cell water is converted to steam,
causing the cell to explode. Minimal later thermal tissue damage, but poor thermal
Laproscopic instruments diameter and length ranges - Answer -2-10mm, 30-45cm
Hopkins rod lens - Answer -light has to travel back through the rod to capture the
image.
Decreasing light in the camera for... - Answer -decreasing diameter, increasing scope
angle (ie 5mm and 30 degree has less light than 10mm 0 degree)
When is zero degree scope most useful - Answer -when working in a small area
directly in line with the scope and ports, like the pelvis
How to check fiber optics light connection - Answer -black dots= broken fibers
Why does it fog up? - Answer -temperature and humidity discrepancy between the OR
and body
Tools for defogging - Answer -FRED antifog (must dry before putting back in), put
laparoscope in hot water
Methods to clean a smudged lens - Answer -gently wipe on clean tissue (liver, uterus,
bowel), remove scope and clean with hot water and gauze
Insufflation gas type and reasoning - Answer -CO2- readily available, inexpensive, non
combustable, warmed and humidified better
High flow insufflation - Answer -10 or more L per minute
Preventing loss of pneumo with suctioning - Answer -keep suction tip below the fluid
level
Most common light source - Answer -300W xenon lamp
Troubleshooting steps: gas preop - Answer -1. Check that co2 tank is full
2. Check co2 tank gasket is secured
3. Check that spare co2 tank is available in the OR
Troubleshooting steps: image - Answer -1. Check that the monitor is plugged in and
turned on 2. Check that all cables are connected securely
Troubleshooting steps: loss of working space: insufflator settings: measured pressure is
the same or higher than the preset pressure - Answer -1. The patient may not be
adequately relaxed or there is a mechanical block of gas flow
, 2. Inspect abdomen for rhythmic muscle contraction and palpate the abdomen for
firmness
3. Check port valves to make sure they are open
4. Check for kinks in tubing and make sure no one is standing on them
Troubleshooting steps: loss of working space: insufflator settings: low pressure and high
flow rate - Answer -1. There is a leak in the insufflation circuit
2. Check that the tubing has not become disconnected from insufflator or port
3. Check that all valves are closed
4. Check all port sites for leaking co2
5. Check for foley catheter bag distention or bowel distention
Troubleshooting steps: loss of working space: insufflator settings: low pressure and no
flow - Answer -1. Make sure that the insufflator power is on
2. Check gas level in the tank
Troubleshooting steps: loss of working space: complete loss of operative image -
Answer -1. Check for disconnected power cords, video cables
2. Check for blown light source bulb
3. Check for disconnected light cable
Monopolar electrosurgery curcuit - Answer -electrical surgical unit-->active electrode--
>patient tissue-->dispersive electrode (grounding pad)
Low frequency from wall source to high frequency at active electrode
Monopolar: tissue coagulation - Answer -occurs as a result of tissue heating and
protein denaturation.
Monopolar: desiccation - Answer -tissue temp rises--->water is evaporated from the
tissue--> increased impedance---> electricity stops flowing because of increased
resistance-->tissue turns brown, bubbles and steams.
Hemostasis due to fibrous binding between dehydrated, denatured cells of vessel
endothelium
Monopolar: current density - Answer -amount of current flowing through cross sectional
area.
Directly proportional to power, inversely related to tissue resistance
Ie larger the area, less current density
Monopolar: cut mode - Answer -heat tissue quickly. Cell water is converted to steam,
causing the cell to explode. Minimal later thermal tissue damage, but poor thermal
