FLS WRITTEN EXAM 2025-2026
FUNDAMENTALS OF LAPAROSCOPIC
SURGERY WRITTEN EXAM 120
QUESTIONS AND ANSWERS
Laparoscope diameters
2-10 mm
Laparoscope lengths
30-45 cm
Hopkins Rod lens system
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?
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?
decreasing diameter, increasing length
0 degree laparocope most useful?
when structures most in line with the trocars and in small places
(deep pelvis, high mediastinum)
30- and 45-degree laparocope
offer more flexibility/versatility than 0 degree (but need more
skills)
Troubleshooting smudge on laparoscope?
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
decreases postop pain and temperature (compared to gas
directly from cylinder)
but is not clinically significant in cases < 90min
High powered light source wattage?
300 watt Xenon lamp
"Picture in Picture" feature
· 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 =
o Patient may not be sufficiently relaxed or there is obstruction
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 =
= 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
coag, cut, blend
FUNDAMENTALS OF LAPAROSCOPIC
SURGERY WRITTEN EXAM 120
QUESTIONS AND ANSWERS
Laparoscope diameters
2-10 mm
Laparoscope lengths
30-45 cm
Hopkins Rod lens system
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?
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?
decreasing diameter, increasing length
0 degree laparocope most useful?
when structures most in line with the trocars and in small places
(deep pelvis, high mediastinum)
30- and 45-degree laparocope
offer more flexibility/versatility than 0 degree (but need more
skills)
Troubleshooting smudge on laparoscope?
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
decreases postop pain and temperature (compared to gas
directly from cylinder)
but is not clinically significant in cases < 90min
High powered light source wattage?
300 watt Xenon lamp
"Picture in Picture" feature
· 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 =
o Patient may not be sufficiently relaxed or there is obstruction
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 =
= 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
coag, cut, blend
