FLS Clip Application 2

Question 1

A standard medium-large titanium clip is typically appropriate for structures with a diameter up to:

Accepted Answer

9 mm

Answer

3 mm

Answer

5 mm

Answer

12 mm

Question 2

When using a 10 mm clip applier, the surgeon notices the jaws cannot fully close around the cystic duct. What is the most appropriate next step?

Accepted Answer

Dissect more tissue to thin the duct before re-applying

Answer

Apply additional clips side by side to complete occlusion

Answer

Use electrocautery to coagulate the duct instead

Answer

Convert to open surgery immediately

Question 3

Which of the following best describes the 'lock-out' feature found on many laparoscopic clip appliers?

Accepted Answer

Prevents accidental clip deployment when not in the operative field

Answer

Prevents firing when the battery is low

Answer

Prevents the device from firing if the jaws are not fully closed around a structure

Answer

Locks the clip in place after deployment to prevent migration

Question 4

During laparoscopic cholecystectomy, a clip is inadvertently placed across what appears to be the common hepatic duct. What is the immediate recommended action?

Accepted Answer

Immediately convert to open surgery for biliary reconstruction

Answer

Remove the clip with the clip applier jaws and continue the case

Answer

Leave the clip in place and proceed with cholecystectomy

Answer

Apply a second clip to reinforce and complete the transection

Question 5

What is the advantage of using polymer locking clips (e.g., Hem-o-lok) over standard titanium clips for laparoscopic procedures?

Accepted Answer

They provide a self-locking mechanism reducing risk of dislodgement

Answer

They are MRI-compatible with zero artifact

Answer

They are absorbed within 30 days eliminating long-term foreign body

Answer

They require less dissection clearance around the vessel

Question 6

In the FLS box trainer, clip application tasks are designed to assess which fundamental laparoscopic skill?

Accepted Answer

Depth perception and bimanual tissue manipulation in a 2D video environment

Answer

Speed of pneumoperitoneum establishment

Answer

Ability to switch between energy devices during a procedure

Answer

Trocar placement accuracy under direct vision

Question 7

When applying clips to the cystic artery, which anatomical variant most increases the risk of an inadequate clip placement?

Accepted Answer

A short cystic artery arising directly from the right hepatic artery

Answer

A replaced right hepatic artery arising from the superior mesenteric artery

Answer

An accessory cystic artery supplying the gallbladder fundus

Answer

A cystic artery arising from the gastroduodenal artery