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

Medium-large clips are designed for structures up to approximately 9 mm in diameter; structures larger than this require larger clips or an alternative occlusion method.

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

Additional dissection to remove pericholecystic fat from the cystic duct allows the clip to fully encircle and occlude it; applying clips on a thick structure risks incomplete closure.

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

The lock-out mechanism prevents accidental firing of clips when the jaws are open and not positioned around a structure, improving safety during instrument manipulation.

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

Injury to the common hepatic duct requires immediate conversion to open surgery for proper biliary reconstruction; attempting laparoscopic correction risks further injury.

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

Polymer locking clips feature a ratcheting mechanism that locks them in place once applied, significantly reducing the risk of accidental dislodgement compared to non-locking titanium clips.

FLS - Fundamentals of Laparoscopic Surgery Practice Test

FLS - Fundamentals of Laparoscopic Surgery Practice Test

FLS Clip Application 2