FLS Frequently Asked Questions
Answers to frequently asked questions about FLS and the Limbs & Things FLS trainer.
What is the FLS program mission?
To provide surgical residents, fellows and practicing surgeons an opportunity to learn the fundamentals of laparoscopic surgery in a consistent, scientifically accepted format; and to test cognitive, surgical decision-making, and technical skills, all with the goal of improving the quality of patient care.
About FLS
The Fundamentals of Laparoscopic Surgery program, (FLS), is a comprehensive web-based education module and assessment tool, designed to teach the fundamental knowledge, judgment and technical skills of basic laparoscopic surgery.
A combination of cognitive learning, hands-on skills training and a proctored exam ensures a minimum standard of care for all patients who undergo laparoscopic surgery, and a way for trainees and surgeons to assess and document their skills.
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.
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.
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.
To participate in the program, visit the FLS Testing Information page to learn more about the process and how to apply.
This page had all the essential links and forms you will need to begin your training for the FLS assessment and exams, including:
- FLS order form
- Guides for registration and test appointments
- Further details on modules and the written components of the FLS assessment
About FLS Trainer Boxes
FLS Trainer Boxes are designed for residents and practicing physicians, to aide in the development of psychomotor skills and dexterity that’s required when performing laparoscopic surgery.
These portable units and their accessories can be used in a variety of tasks to simulate specific surgical techniques.
When studying for the FLS exam, you can use any laparoscopic trainer and have a similar training experience. However, as our FLS Trainer Box is the standardized exam model used within the FLS Manual Skills Exam, it can be beneficial in developing familiarity with the model, reducing anxiety and highlighting gaps in knowledge when using it while training.
About the FLS Curriculum
Yes, the FLS's didactic curriculum covers interactive patient scenarios and manual skills training, and contains printable text reviews and practise questions.
Yes, this curriculum is specifically designed for use in residency training programs in preparation for the skills portion of the FLS exam.
The Training Curriculum outlined in this protocol is proficiency-based, whereby trainees are oriented to the materials and self-practice until expert-derived performance levels are reached. Residents may practice as much or as little as needed in order to acquire the validated skills incorporated into the FLS exam.
This protocol ensures that all trainees achieve an excellent level of performance and has correlated with a uniform successful passing score according to the FLS technical skills testing criteria. This curriculum is recommended for all resident levels.
The assessment component is a two-part, proctored exam that covers cognitive knowledge and manual skills.
The cognitive component is a timed multiple-choice exam administered via computer. It is designed to test the understanding and application of the basic fundamentals of laparoscopy with emphasis on clinical judgment or intra-operative decision-making.
The manual skills component evaluates skills based on efficiency (speed) and precision (accuracy) of the surgeon’s maneuvers using the FLS Laparoscopic Trainer Box. The test consists of five non-procedure specific simulation tasks incorporating most of the psychomotor skills necessary for basic laparoscopic surgery.
About the FLS Exam
The exam is a two-part assessment consisting of a computer-based multiple-choice cognitive assessment and a performance-based manual skills assessment (that is broken down into 5 individual tasks).
- Task 1: Peg Transfer - tests hand-eye coordination and dexterity by moving colored pegs around the field of vision
- Task 2: Precision Cutting - tests ambidexterity, hand-eye coordination and depth perception
- Task 3: Ligating Loop - tests hand-eye coordination and accuracy ligating tissue with a ligating loop (endoloop)
- Task 4: Suture with Extracorporeal Knot - tests external knot tying skills using Penrose Drains
- Task 5: Suture with Intracorporeal Knot - tests internal knot tying skills using Penrose Drains
Completing both components demonstrates the candidate has the required knowledge, judgment and technical skills that are essential to performing basic laparoscopic surgery.
The manual skill assessment consists of five simulation exercises reflecting skills uniquely required in laparoscopic surgery. This includes: ambidexterity, depth perception, hand-eye coordination, controlled movement of instruments and efficiency of movement. Task performance is scored on both efficiency (time) and precision (accuracy).
The computer-based cognitive assessment is made up of multiple-choice questions, including visual and clinical scenarios. It has been specifically designed to test the understanding and application of the basic fundamentals of laparoscopy, with emphasis on clinical judgment and intra-operative decision-making.
Limbs & Things, through the fls-products website, only supply the FLS training equipment needed to practice for the Fundamentals of Laparoscopic Surgery exam. Anything related to participation in FLS assessments and exams needs to be purchased and registered with FLS/SAGES, links below.