FLS EXAMINATION / RECENT VERSION WITH
WELL-DETAILED QUESTIONS AND RELIABLE
ANSWERS / GUARANTEED PASS / ALREADY
GRADED A+
What are the laparoscope diameters?
2-10mm
Which degree scope is best for a field in line with port?
0 degree
How to prevent fogging of scope?
Use anti fog solution or put scope in hot water/hot bath
What is the most commonly used light source?
300 W Xenon lamp
What if there is initial low pressure and high flow rate at entry?
Leak in insufflator circuit, make sure everything plugged in correctly
Benefits of monopolar
Tissue is heated quickly, less thermal damage/coagulation
Monopolar voltage/frequency
Low voltage/High frequency
What does coagulation mode do?
Repid surface heating with shallow depth of necrosis, intermittent
wave form with higher voltage
Risk of monopolar
Current can be diverted through unintentional pathways, leading to
inadvertent tissue injury. Don't use hybrid ports that mix metal with
plastic
,Why do you need a grounding pad for monopolar?
Capacitative coupling - transfer of energy between two conductors
separated by an insulator, transfer to passive electrode. Can release
with tissue injury, but no issue if ground plate is working as capacitor
can't store the charge
Benefits of bipolar
lower energy, producing less lateral tissue damage and necrosis.
Don't need a grounding pad
Risk of bipolar
Risk of cutting patient vessels before adequate sealing, and device
doesn't work if there is metal between the jaws
Risk of ultrasonic dissection (harmonic)
Active blade can injure something due to high frequency (50mHz)
Discontinue aspirin day of surgery?
No
How to enter in patient with bowel obstruction?
Direct visualization
Cut vs Coag
cut - heat tissue quickly to convert cell water to steam, lysing the cell
Coag - heat more widely dispersed, less cutting action
smaller tissue area, greater current density and faster heating
e.g. Bovie tip
Cut mode
- Low voltage
- High frequency
- Continuous waveform
- Heats tissue quickly; cell water converts to steam and causes cell to
explode
Coagulation mode
- High voltage
- Low frequency
- Intermittent waveform
- Rapid tissue heating, shallow depth of necrosis
- Non-contact: relies on sparking to tissue
, Capacitive coupling
Transfer current from active electrode through insulation to passive
electrode- electrode to plastic part another LSC instrument
- if constant contact w/ tissue will not store energy and no injury
Direct coupling
monopolar instrument in direct contact w/ metal portion of another
instrument
Besides capacitative coupling and direct coupling, other hazards of
electrocautery
- Current diversion
- Narrow return circuit
Bipolar
- forceps w/ two twins (one active other return)
- no pt return electrode required)
- no capacitative coupling
- works in "wet" operative field
- less thermal spread compared to monopolar
bipolar seals vessels up to _____ mm in diameter
7 mm
ultrasonic coagulation shears seals vessels up to ____ mm in
diameter
5 mm
ultrasonic coagulation shears
- combo compression and friction
- ONE active blade
- monopolar capacity w/ the one blade
- no capacitative coupling
- high power (MAX): cut
- low power (MIN): coag
How many days prior to surgery does warfarin has to be
discontinued?
3 days
ASA 2
Mild to moderate systemic disease
WELL-DETAILED QUESTIONS AND RELIABLE
ANSWERS / GUARANTEED PASS / ALREADY
GRADED A+
What are the laparoscope diameters?
2-10mm
Which degree scope is best for a field in line with port?
0 degree
How to prevent fogging of scope?
Use anti fog solution or put scope in hot water/hot bath
What is the most commonly used light source?
300 W Xenon lamp
What if there is initial low pressure and high flow rate at entry?
Leak in insufflator circuit, make sure everything plugged in correctly
Benefits of monopolar
Tissue is heated quickly, less thermal damage/coagulation
Monopolar voltage/frequency
Low voltage/High frequency
What does coagulation mode do?
Repid surface heating with shallow depth of necrosis, intermittent
wave form with higher voltage
Risk of monopolar
Current can be diverted through unintentional pathways, leading to
inadvertent tissue injury. Don't use hybrid ports that mix metal with
plastic
,Why do you need a grounding pad for monopolar?
Capacitative coupling - transfer of energy between two conductors
separated by an insulator, transfer to passive electrode. Can release
with tissue injury, but no issue if ground plate is working as capacitor
can't store the charge
Benefits of bipolar
lower energy, producing less lateral tissue damage and necrosis.
Don't need a grounding pad
Risk of bipolar
Risk of cutting patient vessels before adequate sealing, and device
doesn't work if there is metal between the jaws
Risk of ultrasonic dissection (harmonic)
Active blade can injure something due to high frequency (50mHz)
Discontinue aspirin day of surgery?
No
How to enter in patient with bowel obstruction?
Direct visualization
Cut vs Coag
cut - heat tissue quickly to convert cell water to steam, lysing the cell
Coag - heat more widely dispersed, less cutting action
smaller tissue area, greater current density and faster heating
e.g. Bovie tip
Cut mode
- Low voltage
- High frequency
- Continuous waveform
- Heats tissue quickly; cell water converts to steam and causes cell to
explode
Coagulation mode
- High voltage
- Low frequency
- Intermittent waveform
- Rapid tissue heating, shallow depth of necrosis
- Non-contact: relies on sparking to tissue
, Capacitive coupling
Transfer current from active electrode through insulation to passive
electrode- electrode to plastic part another LSC instrument
- if constant contact w/ tissue will not store energy and no injury
Direct coupling
monopolar instrument in direct contact w/ metal portion of another
instrument
Besides capacitative coupling and direct coupling, other hazards of
electrocautery
- Current diversion
- Narrow return circuit
Bipolar
- forceps w/ two twins (one active other return)
- no pt return electrode required)
- no capacitative coupling
- works in "wet" operative field
- less thermal spread compared to monopolar
bipolar seals vessels up to _____ mm in diameter
7 mm
ultrasonic coagulation shears seals vessels up to ____ mm in
diameter
5 mm
ultrasonic coagulation shears
- combo compression and friction
- ONE active blade
- monopolar capacity w/ the one blade
- no capacitative coupling
- high power (MAX): cut
- low power (MIN): coag
How many days prior to surgery does warfarin has to be
discontinued?
3 days
ASA 2
Mild to moderate systemic disease
