Fundamentals Of Laparoscopic Surgery (FLS) Practice Exam

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Name two safety steps for establishing pneumoperitoneum.
Correct Answer:
Selecting an appropriate entry technique (Veress or open), confirming insufflation.
Explanation:
Establishing pneumoperitoneum safely hinges on how you gain access and how you verify that the space is truly the peritoneal cavity. The two safety steps are choosing an appropriate entry technique (Veress needle versus open/Hasson) and confirming that insufflation has been achieved correctly. Selecting the right method for entering the abdomen reduces the risk of injuring internal organs or vessels during access, and it accounts for patient factors such as prior surgeries or adhesions. After entry, confirming insufflation ensures the gas is in the peritoneal cavity, at a safe pressure, and that there isn’t extraperitoneal gas or malposition, which validates that a true pneumoperitoneum has been established. Relying on only one of these steps falls short: confirming insufflation alone doesn’t address the safest way to gain entry, excessive insufflation rate is dangerous, and entering through a nonstandard site like the left upper quadrant is not a reliable safety measure.

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