1. About FLS

What is FLS?

The Fundamentals of Laparoscopic Surgery program is a comprehensive, web-based educational module and assessment tool designed to teach the fundamental knowledge, judgment and technical skills required in basic laparoscopic general surgery. FLS is a joint educational offering of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES and the American College of Surgeons (ACS) Division of Education. For more information please visit FLS Program.

What do I learn from the FLS curriculum?

FLS includes a multimedia presentation of didactic content and “watch & do” exercises that focus on manual skills training. The content is available in a web-based format accessed online.

I’m a practicing surgeon. Why would I need the FLS Program?

Many surgeons who were already in practice during the advent of the laparoscopic revolution learned basic information and skills that were still a work in progress. FLS will help to refresh those cognitive and technical skills and provides you with a way to document those skills.

WHAT can i purchase from fls?

FLS packages can be structured to meet your needs. For pricing information or to purchase the online multimedia curriculum and test voucher please visit FLS program to download an order form.

how do i purchase the fls program?

Download an Order Form by visiting FLS Program or call the SAGES office at 310.437.0544, ext. 137, and ask for one to be faxed or e-mailed to you. Complete the Order Form and return it with payment by check or credit card. If a purchase order is used, all payments must be made within 30 days.


2. FLS Trainer Box

What is the fls trainer box?

The FLS Trainer Box is a device for residents and practicing physicians to develop psychomotor skills and dexterity required during the performance of basic laparoscopic surgery. It is a portable unit that includes a set of accessories used to simulate specific surgical techniques.

do i have to buy the fls trainer box?

No - a different trainer box or simulator may be used to practice the FLS tasks. However, because the FLS Exam is a standardized, high-stakes exam, you must take the FLS manual skills test on the FLS Trainer Box.

Have there been any changes to the fls box since limbs & things began manufacturing the product?

Yes, there is a current recall of the FLS magnetic top that will continue through to September 6, 2016. This recall is MANDATORY for testing centers and voluntary for all other customers. Limbs & Things is in the process of contacting all customers who are eligible for the recall. This recall will be FREE of CHARGE to the customer.

If you feel that you are eligible for the recall or have other questions about the FLS box, please contact the customer service department:

Hours: Monday–Friday, 8am – 5pm EST

Toll Free Telephone: (866) 465-4627

Email: customerservice@limbsandthings.com

what is the new version of the trainer box like?

LTI began manufacturing the new Trainer box in the spring of 2015. The new FLS Trainer Boxes have an updated look and some refinements making the box easier to assemble and repair.  The basic parameters and dimensions of the box remain the same and meet all requirements of the FLS program.

will i still be able to use my older fls trainer box i purchased previously? 

Yes, you are able to use the FLS trainer boxes purchased previously.  All FLS trainer boxes and accessories should be ordered from Limbs & Things through their special FLS website.

do i have to buy a new box through limbs & things? 

Yes, you are able to use the FLS trainer boxes purchased previously.  All FLS trainer boxes and accessories should be ordered from Limbs & Things through their special FLS website.

can i still use the accessories and disposables i purchased previously? WILL I HAVE TO BUY NEW PRODUCTS THROUGH LTI?

Yes, previous FLS accessories (gauze, pegboard, red foam organs, etc.) are still acceptable for use during FLS skills training and testing. Orders for additional FLS accessories or materials should be placed with LTI, through their special FLS website. If you run out and need to replace any accessories urgently, please contact the Limbs & Things customer service team at (912) 629-0357, Monday – Friday, 8:30am-5:00pm EST.


The basic parameters, dimensions and accessories of the FLS Trainer System remain the same, and there will be no advantage or disadvantage to taking the skills test on the new version of the Trainer Box. The skills test tasks and scoring will not be affected.


3. FLS Exam

What is the fls exam?

The exam includes two assessments: a computer-based multiple-choice cognitive assessment and a performance-based manual skills assessment consisting of five skills performed on the FLS Trainer Box. Those who successfully complete both components will have demonstrated the knowledge, judgment and technical skills fundamental to the performance of basic laparoscopic surgery.

Who is eligible for the fls exam?

Anyone is eligible to review the curriculum, but FLS certification is limited to medical residents, fellows, and practicing general surgeons, gynecologists, urologists, surgical oncologists and other physicians.

What is covered in the fls manual skills exam?

The manual skill assessment consists of the five simulation exercises reflecting skills uniquely required in laparoscopic surgery such as ambidexterity, depth perception, hand-eye coordination and controlled movement of instruments, and efficiency of movement. The task performance is scored on both efficiency (time) and precision (accuracy).

What is the cognitive assessment?

The cognitive assessment consists of multiple-choice questions, some of which include visuals and clinical scenarios. It is computer-based and designed to test the understanding and application of the basic fundamentals of laparoscopy with as much emphasis as possible on clinical judgment or intra-operative decision-making.

how much time will it take to complete the fls exam?

You will have 90 minutes to complete the multiple-choice cognitive assessment. The manual skills assessment includes the five designated skills administered on the FLS Trainer Box and lasts approximately 30-45 minutes. Both are administered by a trained FLS proctor.

where can i take the fls exam?

You can take the exam at the Annual SAGES Meeting, at the ACS Clinical Congress, or at a FLS Regional Test Center. Visit FLS Program to see a list of U.S. and Canada FLS Test Centers. For groups of eight or more within the U.S. and Canada, onsite testing may be purchased or, for surgical residency programs in the U.S. and Canada, may be provided under the Covidien Educational Fund.

when will i receive my fls exam scores?

Score reports will be mailed approximately three weeks after the testing date. For privacy reasons, scores will not be transmitted by telephone or facsimile. Those who successfully complete both the educational and assessment components will also receive a certification of completion confirming that they have demonstrated the knowledge, judgment and technical skills fundamental to the performance of basic laparoscopic surgery.

can i take the fls exam?

If you fail one or both parts of the assessment, you must retake whatever part was not completed successfully within 18 months of your original exam date, and there is a $125.00 fee to retest. If one or both are still not passed after the first retake, then the participant must wait 6 months for the next retake (again, this must occur within 18 months of your original exam date).

After three retakes, or 18 months, a new registration process is required and both assessments must be undertaken anew, even if one had been passed previously.

can i receive cme credits?

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. FLS 2.0 is accredited for a maximum of 12 AMA PRA Category 1 Credit(s), which is also designated as self-assessment CME credit, applicable to Part 2 of the American Board of Surgery (ABS) Maintenance of Certification (MOC) requirements. CME will be awarded to those who successfully complete the FLS exam beginning 9/1/2011.

does my certificate expire?

Effective 10/1/2012 FLS no longer issues certificates that are valid indefinitely; instead, all certificates are dated and individuals must be recertified every 10 years by successful completion of the entire test (both cognitive and skills components).

• For certificates issued on 10/1/2012 or later, recertification is required no later than ten years from the original certificate issue date, but recertification may be sought as early as seven years from the original certificate issue date.

• “Grandfathering” – For certificates issued prior to 10/1/2012, recertification must be completed by 10/1/2022 regardless of the original certificate issue date. Individuals may initiate the recertification process as early as seven years from the original certificate issue date (i.e. ten year time limit starts 10/1/2012).

Recertification – Individuals wanting to maintain FLS certification should purchase an FLS Individual Package or an FLS Educational Package at the full price. Test scheduling and test administration procedures are the same for those seeking recertification as those taking the exam the very first time. Both test components must be completed with the same passing score as those taking the exam the very first time. Individuals who pass the exam will be issued a new certificate with a new effective date. Individuals who allow their certificate to expire will be classified in the same category as those who never attempted the FLS test, and those who have attempted the test but have not achieved a passing score.


4. FLS Vouchers

do i have to purchase fls vouchers and online didatics through limbs & things as well?

No, you will still purchase FLS test vouchers and access to the online didactics through the SAGES FLS program office.  For more information, please visit FLS Program 

what is a testing voucher?

A testing voucher is the “admittance ticket” needed in order to take the FLS exam. Each voucher has a unique identification number and can be redeemed one time only. All test vouchers, including retest vouchers, have an expiration date printed on the upper right hand corner, and tests must be completed by this date. The initial test must be completed within 12 months of the voucher purchase.

If the FLS test is not successfully completed, a “re-test” voucher may be purchased at a lesser price within 18 months of the original exam date.