FLS Module 3 - basic laparoscopic
procedures Questions And Answers 100%
Correct
What are some of the newest developments in laparoscopic surgery? Robotic assistance,
single port site procedures, Natural Orifice Translumenal Endoscopic Surgery (NOTES), and
intrauterine fetal surgery
List 5 laparoscopic procedures that are performed on newborn infants appendectomy,
undescended testes, anti-reflux surgery, pectus repair, PDA, intestinal atresia, pyloromyotomy,
and surgery for Hirschsprung's disease
Indications for diagnostic laparoscopy elective - cancer staging, chronic abdominal pain
urgent - small bowel obstruction, vs ileus
Emergent - trauma, suspected iatrogenic injury, perforated viscous
During what procedures could you inadvertently enter the peritoneal cavity and subsquently need
to perform a diagnostic laparoscopy? hysteroscopy, endoscopy
, FLS Module 3 - basic laparoscopic
procedures Questions And Answers 100%
Correct
Key elements of performing a lysis of adhesions Use both blunt and sharp dissection with
gentle traction on tissue. Be cautious and sparingly use energy sources for hemostasis to avoid
thermal spread
What is the best position for patients getting surgery on the upper abdomen? Arms on arm
boards, reverse trendelenburg position with a footboard and safety strap on lower thighs to keep
patient from sliding. Monitors placed at head of table for viewing operative field.
What is the key to patient positioning? Where would you place your initial port for a diagnostic
lap where you need to view the entire abdomen? After your initial port, where do you place
additional ones? Maximize the ergonomics of the surgeon and assistant. Usually initiate
access in LUQ and 2 additional ports can also be placed in the left abdomen (then surgeon and
assistant can stand on left side together). This allows the entire abdomen to be visualized except
for immediately below the ports or lateral to the ports.
General principles of diagnostic lap of the liver Angled scope
Tools for biospy and hemostasis
May need ultrasound to visualize structures under the surface.
To see anteriorly: may need adhesiolysis
, FLS Module 3 - basic laparoscopic
procedures Questions And Answers 100%
Correct
To see posteriorly: may need special liver retractor or careful use of blunt instruments
Why would you do a diagnostic lap of the anterior abdominal wall?
What area should you enter the abdomen?
What degree scope should you use? To look for evidence of post-op bleeding, adhesions,
hernia or tumor.
Left upper quadrant, unless the area of interest is in the LUQ.
30 degree scope
Best position and port placement for diagnostic pelvic laparoscopy - Tucked arms so
surgeon can be ergonomically favorable.
- Trendelenburg
- Ports at or above the umbilicus
- Retract uterus with manipulator or suture retraction to the abdominal wall.
Diagnostic lap for suspected appendicitis - Left arm tucked, allowing surgeon and
assistant to stand on left side.
procedures Questions And Answers 100%
Correct
What are some of the newest developments in laparoscopic surgery? Robotic assistance,
single port site procedures, Natural Orifice Translumenal Endoscopic Surgery (NOTES), and
intrauterine fetal surgery
List 5 laparoscopic procedures that are performed on newborn infants appendectomy,
undescended testes, anti-reflux surgery, pectus repair, PDA, intestinal atresia, pyloromyotomy,
and surgery for Hirschsprung's disease
Indications for diagnostic laparoscopy elective - cancer staging, chronic abdominal pain
urgent - small bowel obstruction, vs ileus
Emergent - trauma, suspected iatrogenic injury, perforated viscous
During what procedures could you inadvertently enter the peritoneal cavity and subsquently need
to perform a diagnostic laparoscopy? hysteroscopy, endoscopy
, FLS Module 3 - basic laparoscopic
procedures Questions And Answers 100%
Correct
Key elements of performing a lysis of adhesions Use both blunt and sharp dissection with
gentle traction on tissue. Be cautious and sparingly use energy sources for hemostasis to avoid
thermal spread
What is the best position for patients getting surgery on the upper abdomen? Arms on arm
boards, reverse trendelenburg position with a footboard and safety strap on lower thighs to keep
patient from sliding. Monitors placed at head of table for viewing operative field.
What is the key to patient positioning? Where would you place your initial port for a diagnostic
lap where you need to view the entire abdomen? After your initial port, where do you place
additional ones? Maximize the ergonomics of the surgeon and assistant. Usually initiate
access in LUQ and 2 additional ports can also be placed in the left abdomen (then surgeon and
assistant can stand on left side together). This allows the entire abdomen to be visualized except
for immediately below the ports or lateral to the ports.
General principles of diagnostic lap of the liver Angled scope
Tools for biospy and hemostasis
May need ultrasound to visualize structures under the surface.
To see anteriorly: may need adhesiolysis
, FLS Module 3 - basic laparoscopic
procedures Questions And Answers 100%
Correct
To see posteriorly: may need special liver retractor or careful use of blunt instruments
Why would you do a diagnostic lap of the anterior abdominal wall?
What area should you enter the abdomen?
What degree scope should you use? To look for evidence of post-op bleeding, adhesions,
hernia or tumor.
Left upper quadrant, unless the area of interest is in the LUQ.
30 degree scope
Best position and port placement for diagnostic pelvic laparoscopy - Tucked arms so
surgeon can be ergonomically favorable.
- Trendelenburg
- Ports at or above the umbilicus
- Retract uterus with manipulator or suture retraction to the abdominal wall.
Diagnostic lap for suspected appendicitis - Left arm tucked, allowing surgeon and
assistant to stand on left side.
