FLS MODULE 3 - BASIC LAPAROSCOPIC PROCEDURES
CERTIFICATION SCRIPT 2026 QUESTIONS WITH
SOLUTIONS GRADED A+
● Indications for using local anesthesia in laparoscopy. Answer: no conclusive evidence
that it will prevent visceral pain but can be helpful for tubal ligations, diagnostic laparoscopies
or hernia repairs
● Types of local anesthesia. Answer: Bupivacaine, Ropivacaine, Lidocaine
● Advantages of epidural anesthesia. Answer: Decreased post-operative anesthesia and
decreased length of post-op ileus as well as improved muscle relaxation.
● What medication can you give to prevent bradyarrhythmias in lap surgery?. Answer:
Prophylactic atropine prevents bradyarrhythmias caused by pneumoperitoneum but causes
excessive dry mouth so better to give intra-op rather than pre-op. Can give glycopyrrolate
● What class of meds are used pre-op for relaxation of patients. Answer: Benzos. For
relaxation and also to give amnesia.
● What meds should patient take prior to surgery?. Answer: H2 blocker or non-particulate
antacid sodium citrate to minimize effects of aspiration should it occur. Also any chronic
cardiovascular or pulmonary medications
● What components are important for anesthetizing a patient for laparoscopy. Answer:
IV induction + GETA and neuromuscular blockade
● Can you use an LMA for laparoscopy?. Answer: controversial
● Does the use of nitrous oxide as an insufflating gas cause bowel distension. Answer:
usually not seen (rare) unless patient has a bowel obstruction
● Common patient positions in surgery. Answer: Supine, Trendelenburg, Reverse T-burg,
Lithotomy, lateral decubitus
● How should you position the arms in a pelvic laparoscopic surgery. Answer: Arm
tucked to the sides. Ensure hands are not near a break in the table to avoid a hand injury if
table is flexed during surgery
, ● How should you position the arms in an upper abdominal surgery. Answer: Arms
abducted to 90 degree angle but not greater than 90 to avoid brachial plexus stretch injury
● What are some key elements to keeping patient safe in a steep reverse
Trendelenburg position. Answer: Foot board to keep patient from sliding, safety belt to keep
patients knees from buckling
● Keys to safely positioning a patient in lithotomy position. Answer: Fit the equipment to
the patient, not the patient to the equipment. Allen stirups preferable to candy cane stirrups
given more movements.
● In an omentectomy, what level should the knees be placed in the lithotomy position
for optimal positioning?. Answer: For open surgery such as omenectomy it's important to
make sure the knees are level with the torso to keep the instruments from interfering with the
knees
● Decubitus position precautions. Answer: avoid stretch in brachial plexus, roll in the the
axilla on the dependent side, with a an arm board for the contralateral arm. Can use a bean
bag but it cannot extend too far anterior or posterior to avoid interference with port placement
and manipulation
● What is the risk to using a vacuum sealed bean bag rather than pillows or blankets
for positioning a patient. Answer: Higher risk of pressure injury with the vacuum sealed bag
as it is more firm than pillows or blankets
● What position do you need to consider for adrenal surgery?. Answer: Lateral decubitus
with the table flexed to increase the dimension between the costal margin and the iliac crest.
Allows more space for access to the target organ.
● modified decubitus. Answer: Allows for rotation between supine and lateral decubitus
positioning.
● Surgeries where the modified decubitus position are used. Answer: splenectomy,
nephrectomy, adrenalectomy
● What procedure can be performed using local anesthesia alone or with mild
sedation. Answer: Diagnostic laparoscopy
● Important factors for positioning a patient for laparoscopic surgery. Answer:
Avoidance of position related nerve injuries, prevention of DVT, ensuring adequate exposure
for target organ
CERTIFICATION SCRIPT 2026 QUESTIONS WITH
SOLUTIONS GRADED A+
● Indications for using local anesthesia in laparoscopy. Answer: no conclusive evidence
that it will prevent visceral pain but can be helpful for tubal ligations, diagnostic laparoscopies
or hernia repairs
● Types of local anesthesia. Answer: Bupivacaine, Ropivacaine, Lidocaine
● Advantages of epidural anesthesia. Answer: Decreased post-operative anesthesia and
decreased length of post-op ileus as well as improved muscle relaxation.
● What medication can you give to prevent bradyarrhythmias in lap surgery?. Answer:
Prophylactic atropine prevents bradyarrhythmias caused by pneumoperitoneum but causes
excessive dry mouth so better to give intra-op rather than pre-op. Can give glycopyrrolate
● What class of meds are used pre-op for relaxation of patients. Answer: Benzos. For
relaxation and also to give amnesia.
● What meds should patient take prior to surgery?. Answer: H2 blocker or non-particulate
antacid sodium citrate to minimize effects of aspiration should it occur. Also any chronic
cardiovascular or pulmonary medications
● What components are important for anesthetizing a patient for laparoscopy. Answer:
IV induction + GETA and neuromuscular blockade
● Can you use an LMA for laparoscopy?. Answer: controversial
● Does the use of nitrous oxide as an insufflating gas cause bowel distension. Answer:
usually not seen (rare) unless patient has a bowel obstruction
● Common patient positions in surgery. Answer: Supine, Trendelenburg, Reverse T-burg,
Lithotomy, lateral decubitus
● How should you position the arms in a pelvic laparoscopic surgery. Answer: Arm
tucked to the sides. Ensure hands are not near a break in the table to avoid a hand injury if
table is flexed during surgery
, ● How should you position the arms in an upper abdominal surgery. Answer: Arms
abducted to 90 degree angle but not greater than 90 to avoid brachial plexus stretch injury
● What are some key elements to keeping patient safe in a steep reverse
Trendelenburg position. Answer: Foot board to keep patient from sliding, safety belt to keep
patients knees from buckling
● Keys to safely positioning a patient in lithotomy position. Answer: Fit the equipment to
the patient, not the patient to the equipment. Allen stirups preferable to candy cane stirrups
given more movements.
● In an omentectomy, what level should the knees be placed in the lithotomy position
for optimal positioning?. Answer: For open surgery such as omenectomy it's important to
make sure the knees are level with the torso to keep the instruments from interfering with the
knees
● Decubitus position precautions. Answer: avoid stretch in brachial plexus, roll in the the
axilla on the dependent side, with a an arm board for the contralateral arm. Can use a bean
bag but it cannot extend too far anterior or posterior to avoid interference with port placement
and manipulation
● What is the risk to using a vacuum sealed bean bag rather than pillows or blankets
for positioning a patient. Answer: Higher risk of pressure injury with the vacuum sealed bag
as it is more firm than pillows or blankets
● What position do you need to consider for adrenal surgery?. Answer: Lateral decubitus
with the table flexed to increase the dimension between the costal margin and the iliac crest.
Allows more space for access to the target organ.
● modified decubitus. Answer: Allows for rotation between supine and lateral decubitus
positioning.
● Surgeries where the modified decubitus position are used. Answer: splenectomy,
nephrectomy, adrenalectomy
● What procedure can be performed using local anesthesia alone or with mild
sedation. Answer: Diagnostic laparoscopy
● Important factors for positioning a patient for laparoscopic surgery. Answer:
Avoidance of position related nerve injuries, prevention of DVT, ensuring adequate exposure
for target organ
