FLS Written
FLS Written Exam Questions and
Answers 2025
Laparoscope diameters -Correct Answer ✔2-10 mm
Laparoscope lengths -Correct Answer ✔30-45 cm
Hopkins Rod lens system -Correct Answer ✔light from source to operative field >>
capture and transmit reflected light through the scope and camera couple >> light
sensitive chip in the camera head
Decreasing ability for image capture with what factors? -Correct Answer ✔increasing
length, increasing angle, and decreasing diameter (ex: 5 mm, 30 degree scope admits
less light than a 10 mm, 0 degree scope)
Laparoscopic damage susceptibility increases with which factors? -Correct Answer
✔decreasing diameter, increasing length
0 degree laparocope most useful? -Correct Answer ✔when structures most in line with
the trocars and in small places (deep pelvis, high mediastinum)
30- and 45-degree laparocope -Correct Answer ✔offer more flexibility/versatility than 0
degree (but need more skills)
Troubleshooting smudge on laparoscope? -Correct Answer ✔o Wipe on clean tissue
(liver or bowel)
o Remove scope and clean with towel
o Clean port (newer systems may not need this as no mechanical seal)
Warmed/humidified CO2 -Correct Answer ✔decreases postop pain and temperature
(compared to gas directly from cylinder)
but is not clinically significant in cases < 90min
High powered light source wattage? -Correct Answer ✔300 watt Xenon lamp
"Picture in Picture" feature -Correct Answer ✔· Helpful if need for intra-op of flexible
endoscopy or ultrasound of GI or GU tract, liver ultrasound, hysteroscopy, bile duct
exploration
o Basically smaller picture in corner to show scope imaging + additional images
· Work space decrease in size: Actual pressure higher than set pressure = -Correct
Answer ✔o Patient may not be sufficiently relaxed or there is obstruction
FLS Written
, FLS Written
o Twitch monitors may not represent this well as diaphragm recovery from paralytics
differs from skeletal muscles
o Mechanical obstruction - closed valve on port, kink, standing on tubing
Low pressure and high flow rate = -Correct Answer ✔= leak in system
o tubing disconnected from insufflator or port
o Valve open—check to make sure valves are cloed
o Check all port sites for leaking CO2
o Hollow organs check distension of bowel or bladder catheter
Waveforms -Correct Answer ✔coag, cut, blend
· Tissue effects: -Correct Answer ✔o Vaporization: 'cut', non-contact, deep injury with
minimal lateral damage
o Fulguration: 'coag', non-contact, superficial wide injury
o Desiccation: either, contact with instrument, deep/penetrating injury
--However, 'cut' gives you most thorough desiccation!
Harmonic scalpel -Correct Answer ✔· uses mechanical energy, so no dispersive
electrode needed
o Little lateral injury, good for small vessels
· Ligasure -Correct Answer ✔o Bipolar, continuous waveform, measures tissue
impedance and shuts down as needed
o single application is sufficient!
If jewelry cannot be removed, then? -Correct Answer ✔· use gauze and tape to increase
contact area and to minimize current concentration
· jewelry should not between dispersive electrode and surgical site
Current Density = -Correct Answer ✔Current (amps)/Area (cm2)
Current Density proportional to -Correct Answer ✔power (the current)
Current Density inversely proportional to -Correct Answer ✔o tissue resistance and area
squared
o Smaller the contact area, greater the current density >> faster heating
o Tip of electrode is small, so contacting a small area of tissue generates high current
density
dispersive pad (grounding pad) location -Correct Answer ✔o minimal heating and
maintains low density
-- don't place on hair, bony prominence, or scars which may cause decrease in contact
surface area and increase risk of burns
FLS Written
FLS Written Exam Questions and
Answers 2025
Laparoscope diameters -Correct Answer ✔2-10 mm
Laparoscope lengths -Correct Answer ✔30-45 cm
Hopkins Rod lens system -Correct Answer ✔light from source to operative field >>
capture and transmit reflected light through the scope and camera couple >> light
sensitive chip in the camera head
Decreasing ability for image capture with what factors? -Correct Answer ✔increasing
length, increasing angle, and decreasing diameter (ex: 5 mm, 30 degree scope admits
less light than a 10 mm, 0 degree scope)
Laparoscopic damage susceptibility increases with which factors? -Correct Answer
✔decreasing diameter, increasing length
0 degree laparocope most useful? -Correct Answer ✔when structures most in line with
the trocars and in small places (deep pelvis, high mediastinum)
30- and 45-degree laparocope -Correct Answer ✔offer more flexibility/versatility than 0
degree (but need more skills)
Troubleshooting smudge on laparoscope? -Correct Answer ✔o Wipe on clean tissue
(liver or bowel)
o Remove scope and clean with towel
o Clean port (newer systems may not need this as no mechanical seal)
Warmed/humidified CO2 -Correct Answer ✔decreases postop pain and temperature
(compared to gas directly from cylinder)
but is not clinically significant in cases < 90min
High powered light source wattage? -Correct Answer ✔300 watt Xenon lamp
"Picture in Picture" feature -Correct Answer ✔· Helpful if need for intra-op of flexible
endoscopy or ultrasound of GI or GU tract, liver ultrasound, hysteroscopy, bile duct
exploration
o Basically smaller picture in corner to show scope imaging + additional images
· Work space decrease in size: Actual pressure higher than set pressure = -Correct
Answer ✔o Patient may not be sufficiently relaxed or there is obstruction
FLS Written
, FLS Written
o Twitch monitors may not represent this well as diaphragm recovery from paralytics
differs from skeletal muscles
o Mechanical obstruction - closed valve on port, kink, standing on tubing
Low pressure and high flow rate = -Correct Answer ✔= leak in system
o tubing disconnected from insufflator or port
o Valve open—check to make sure valves are cloed
o Check all port sites for leaking CO2
o Hollow organs check distension of bowel or bladder catheter
Waveforms -Correct Answer ✔coag, cut, blend
· Tissue effects: -Correct Answer ✔o Vaporization: 'cut', non-contact, deep injury with
minimal lateral damage
o Fulguration: 'coag', non-contact, superficial wide injury
o Desiccation: either, contact with instrument, deep/penetrating injury
--However, 'cut' gives you most thorough desiccation!
Harmonic scalpel -Correct Answer ✔· uses mechanical energy, so no dispersive
electrode needed
o Little lateral injury, good for small vessels
· Ligasure -Correct Answer ✔o Bipolar, continuous waveform, measures tissue
impedance and shuts down as needed
o single application is sufficient!
If jewelry cannot be removed, then? -Correct Answer ✔· use gauze and tape to increase
contact area and to minimize current concentration
· jewelry should not between dispersive electrode and surgical site
Current Density = -Correct Answer ✔Current (amps)/Area (cm2)
Current Density proportional to -Correct Answer ✔power (the current)
Current Density inversely proportional to -Correct Answer ✔o tissue resistance and area
squared
o Smaller the contact area, greater the current density >> faster heating
o Tip of electrode is small, so contacting a small area of tissue generates high current
density
dispersive pad (grounding pad) location -Correct Answer ✔o minimal heating and
maintains low density
-- don't place on hair, bony prominence, or scars which may cause decrease in contact
surface area and increase risk of burns
FLS Written
