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FLS (Fundamentals of Laparoscopic Surgery) Written
Exam includes accurate and verified questions
covering laparoscopic techniques, patient safety,
surgical anatomy, instrumentation, procedural
knowledge, and clinical decision-making. Designed for
medical professionals seeking FLS certification as part
of minimally invasive surgical training.
When performing a laparoscopic inguinal hernia repair, which
structure(s) must be carefully identified and avoided to prevent
injury? - ANSWER-The inferior epigastric vessels
Explanation: The inferior epigastric vessels lie in the
preperitoneal space near the inguinal canal, making them at risk
during laparoscopic hernia repairs.
What is the primary risk of using a Veress needle for initial
pneumoperitoneum creation in a morbidly obese patient? -
ANSWER-Failure to access the peritoneal cavity due to thick
abdominal fat
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Explanation: In morbidly obese patients, the Veress needle may
have difficulty reaching the peritoneal cavity due to thick
subcutaneous fat layers, which can increase the risk of injury.
In laparoscopic bowel resection, what is the key reason for
performing mesenteric division through a surgical stapler
instead of traditional manual suturing? - ANSWER-It ensures
quicker hemostasis and reduces operating time
Explanation: Surgical staplers are faster and more reliable than
manual suturing when performing mesenteric division, ensuring
good hemostasis and reducing operating time.
In a laparoscopic Nissen fundoplication, what is the most
common complication that requires conversion to open surgery?
- ANSWER-Splenic injury
Explanation: During laparoscopic Nissen fundoplication, the left
diaphragm and spleen are close to the surgical field, increasing
the risk of splenic injury, which may require conversion to open
surgery.
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In the case of a liver laceration during a laparoscopic procedure,
what is the best immediate approach to control bleeding? -
ANSWER-Apply direct pressure and use bipolar cautery
Explanation: For liver lacerations, applying direct pressure to
control bleeding followed by hemostasis with bipolar cautery is
the best approach. Open surgery is generally not required unless
bleeding cannot be controlled laparoscopically.
When performing a laparoscopic appendectomy, which of the
following would most likely lead to a misdiagnosis of a normal
appendix as inflamed? - ANSWER-Over-insufflation of the
abdomen
Explanation: Over-insufflation can distort the anatomy, making
it difficult to visualize the appendix properly, leading to
potential misdiagnosis.
During laparoscopic cholecystectomy, a surgeon encounters
difficulty dissecting the cystic artery due to a dense fibrotic
tissue in the Calot's triangle. Which of the following steps is the
most appropriate next action? - ANSWER-Convert to an open
procedure for better access
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Explanation: Dense fibrotic tissue can make dissection difficult.
Converting to open surgery allows better visualization and
control in such cases.
Abdominal wall hernia during laparoscopic surgery can occur
during trocar insertion. What is the most effective way to
prevent this? - ANSWER-Use blunt dissection to insert trocars
Explanation: Blunt dissection reduces the risk of injuring
underlying structures during trocar insertion, especially in the
case of obesity or unusual anatomy.
During laparoscopic colorectal surgery, what is the primary
reason for the surgeon to inspect the mesentery before resecting
bowel segments? - ANSWER-To check for signs of ischemia
Explanation: Before bowel resection, inspecting the mesentery
ensures that there is adequate blood supply to the bowel
segments to prevent anastomotic complications.
What is the most appropriate method for performing a gastric
bypass using laparoscopic techniques? - ANSWER-A circular
stapler for anastomosis
FLS (Fundamentals of Laparoscopic Surgery) Written
Exam includes accurate and verified questions
covering laparoscopic techniques, patient safety,
surgical anatomy, instrumentation, procedural
knowledge, and clinical decision-making. Designed for
medical professionals seeking FLS certification as part
of minimally invasive surgical training.
When performing a laparoscopic inguinal hernia repair, which
structure(s) must be carefully identified and avoided to prevent
injury? - ANSWER-The inferior epigastric vessels
Explanation: The inferior epigastric vessels lie in the
preperitoneal space near the inguinal canal, making them at risk
during laparoscopic hernia repairs.
What is the primary risk of using a Veress needle for initial
pneumoperitoneum creation in a morbidly obese patient? -
ANSWER-Failure to access the peritoneal cavity due to thick
abdominal fat
,2|Page
Explanation: In morbidly obese patients, the Veress needle may
have difficulty reaching the peritoneal cavity due to thick
subcutaneous fat layers, which can increase the risk of injury.
In laparoscopic bowel resection, what is the key reason for
performing mesenteric division through a surgical stapler
instead of traditional manual suturing? - ANSWER-It ensures
quicker hemostasis and reduces operating time
Explanation: Surgical staplers are faster and more reliable than
manual suturing when performing mesenteric division, ensuring
good hemostasis and reducing operating time.
In a laparoscopic Nissen fundoplication, what is the most
common complication that requires conversion to open surgery?
- ANSWER-Splenic injury
Explanation: During laparoscopic Nissen fundoplication, the left
diaphragm and spleen are close to the surgical field, increasing
the risk of splenic injury, which may require conversion to open
surgery.
,3|Page
In the case of a liver laceration during a laparoscopic procedure,
what is the best immediate approach to control bleeding? -
ANSWER-Apply direct pressure and use bipolar cautery
Explanation: For liver lacerations, applying direct pressure to
control bleeding followed by hemostasis with bipolar cautery is
the best approach. Open surgery is generally not required unless
bleeding cannot be controlled laparoscopically.
When performing a laparoscopic appendectomy, which of the
following would most likely lead to a misdiagnosis of a normal
appendix as inflamed? - ANSWER-Over-insufflation of the
abdomen
Explanation: Over-insufflation can distort the anatomy, making
it difficult to visualize the appendix properly, leading to
potential misdiagnosis.
During laparoscopic cholecystectomy, a surgeon encounters
difficulty dissecting the cystic artery due to a dense fibrotic
tissue in the Calot's triangle. Which of the following steps is the
most appropriate next action? - ANSWER-Convert to an open
procedure for better access
, 4|Page
Explanation: Dense fibrotic tissue can make dissection difficult.
Converting to open surgery allows better visualization and
control in such cases.
Abdominal wall hernia during laparoscopic surgery can occur
during trocar insertion. What is the most effective way to
prevent this? - ANSWER-Use blunt dissection to insert trocars
Explanation: Blunt dissection reduces the risk of injuring
underlying structures during trocar insertion, especially in the
case of obesity or unusual anatomy.
During laparoscopic colorectal surgery, what is the primary
reason for the surgeon to inspect the mesentery before resecting
bowel segments? - ANSWER-To check for signs of ischemia
Explanation: Before bowel resection, inspecting the mesentery
ensures that there is adequate blood supply to the bowel
segments to prevent anastomotic complications.
What is the most appropriate method for performing a gastric
bypass using laparoscopic techniques? - ANSWER-A circular
stapler for anastomosis
