FLS Program Description

FLS establishes a standard set of didactic information and manual skills serving as a basic curriculum to guide surgical residents, fellows and practicing surgeons in the performance of basic laparoscopic surgery.  By mastering the curriculum and gathering of skills in this inanimate modality, it is expected that surgical residents and surgeons will initiate and carry out their performance of laparoscopy more effectively, with greater skill, greater safety, and with lower complication rates than previously.  The specific aim of FLS is that the knowledge and skills gained by those who master the FLS curriculum will improve the quality and safety of surgical care delivered to their patients.

Click here for an important information bulletin with a complete description of FLS and policies concerning the FLS test.


FLS consists of:

  1. web-based study guides;
  2. hands-on manual skills practice and training via the FLS Laparoscopic Trainer Box; and
  3. an assessment tool that measure your cognitive and technical skills.

Web-based Study Guide

The online study guides cover didactics, interactive patient scenarios and manual skills training, containing printable text reviews and practice questions. The online system allows program coordinators to administer and closely track the progress of their individual users.

If your program is currently enrolled in the online system please download the following instruction manual(s):

Computer/Internet Requirements

  • Windows XP, Vista, Windows 7, Windows 8, Mac OS X,
  • The latest version of your web browser
  • The latest version of Flash
  • Speakers for sound
  • Broadband internet access


FLS Online Didactic Access Instructions

FLS Online Instruction Guide – Viewing Online Content

Technical Skills Training Curriculum

The FLS program may be effectively used to teach and assess both cognitive and technical skill aspects related to laparoscopic surgery. Over the past two years, SAGES FLS committee members have developed a technical skills curriculum specifically designed for use in residency training programs. The curriculum is proficiency-based, whereby trainees are oriented to the materials and self-practice until expert-derived performance levels are reached.

The FLS Laparoscopic Trainer Box allows practice of technical skills to improve dexterity and psychomotor skills.  The simulated laparoscopic manipulation includes instrument navigation, coordination and cutting or knot-tying.  Click here for a written description of the five FLS manual skills. Please also refer to the technical skills curriculum and the skill demonstration videos in the Online Study guides.

Residents may practice as much or as little as needed in order to acquire the validated skills incorporated into the FLS modules. The video materials serve as a robust source of feedback for the learner and additional proctoring is considered optional. 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. We recommend this curriculum for all resident levels. Surgery interns may benefit by mastering these skills early in their training, such that they are better prepared for opportunities in the operating room and can undergo additional training throughout their residency as needed. Similarly, mid-level and senior residents may benefit by ensuring that all trainees have suitable skills to perform a wide array of laparoscopic procedures.

We have partnered with other ongoing national initiatives, and this curriculum is now part of the Basic and Advanced Laparoscopic Skills Modules included in the ACS/APDS National Skills Curriculum Project; detailed information concerning these modules is available through the ACS website, http://elearning.facs.org.


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 intraoperative decision-making.

FLS is currently phasing in a new on line testing process to administer this component. If you’re test center is currently using the on line process please download the following instruction manuals:

Online Testing: Test Center User Guide * For test centers only*

Online Testing: Test Taker Registration Guide

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 exercises incorporating most of the psychomotor skills necessary for basic laparoscopic surgery.