FLS FLS Pneumoperitoneum and Insufflation

Question 1

What is the recommended initial intraabdominal pressure (IAP) for creating pneumoperitoneum in a standard adult laparoscopic procedure?

Accepted Answer

12–15 mmHg

Answer

A working pressure of 12–15 mmHg provides adequate visualization while minimizing hemodynamic and respiratory compromise in most adults.

Question 2

Which gas is most commonly used for laparoscopic insufflation and why?

Accepted Answer

Carbon dioxide — rapidly absorbed and non-flammable

Answer

Carbon dioxide is preferred because it is highly soluble in blood, rapidly eliminated by the lungs, and non-flammable, reducing risk of gas embolism and surgical fire.

Question 3

A sudden drop in end-tidal CO₂ (EtCO₂) combined with cardiovascular collapse during insufflation most likely indicates:

Accepted Answer

CO₂ gas embolism

Answer

A massive CO₂ embolism causes a 'millwheel' murmur, cardiovascular collapse, and a precipitous fall in EtCO₂ as venous return is obstructed.

Question 4

The Veress needle technique relies on a spring-loaded blunt obturator that advances when the needle enters which structure?

Accepted Answer

The peritoneal cavity

Answer

Once the sharp tip passes through the peritoneum and resistance drops, the spring-loaded blunt stylet springs forward to protect intraabdominal organs.

Question 5

Which of the following initial insufflation flow rates is most appropriate when using the Veress needle to confirm correct placement?

Accepted Answer

1–2 L/min

Answer

Starting at a low flow rate (1–2 L/min) allows monitoring of pressure rise; a rapid pressure increase at low flow suggests incorrect placement.

FLS - Fundamentals of Laparoscopic Surgery Practice Test

FLS - Fundamentals of Laparoscopic Surgery Practice Test

FLS FLS Pneumoperitoneum and Insufflation