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FLS, FES, FUSE Training/Certifications

PSSI at Providence Portland Medical Center is a recognized site for Fundamentals of Laparoscopic Surgery (FLS) and Fundamentals of Endoscopic Surgery (FES) skills training through the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). In addition to the skills training, we offer the FES certification exam. The certification has been adopted as a requirement by the American Board of Surgery. Residents and practicing surgeons whose education and continuing medical education emphasis falls within gastrointestinal and endoscopic surgery are welcome at PSSI.

PSSI is also a recognized certification site for the Fundamental Use of Surgical Energy (FUSE) exam . The FUSE didactic materials and exam were designed to inform and promote best practice for the use of electrosurgical, ultrasonic and other energy sources in the OR. Any health care professional who has ever used an energy device in the OR will better understand how it works, when to apply it, and what possible hazards and errors can occur.

Certifications available for Fundamentals of:

Endoscopic Surgery (FES)

The SAGES Fundamentals of Endoscopic Surgery (FES) program is a comprehensive educational and assessment tool designed to teach and evaluate the fundamental knowledge, clinical judgment and technical skills required in the performance of basic gastrointestinal (GI) endoscopic surgery (endoscopy). Our goal is to provide participants with an opportunity to learn the fundamentals of endoscopic surgery in a consistent, scientifically accepted format, and to test cognitive and technical skills – all with the goal of improving the quality of patient care.

FES was designed for medical and surgical residents, fellows, practicing general surgeons, gastroenterologists and other physicians to learn and test basic endoscopic skills required to form a foundation in the practice of flexible endoscopy. The American Board of Surgery (ABS) will soon require anyone applying for board certification in general surgery to complete the FES program, starting with those who finish residency training in the 2017-2018 academic year. FES is also CME accredited.

Learning objectives:


  • Understand indications and contraindications for the basic endoscopic procedures
  • Recognize and manage common complications related to basic endoscopic procedures
  • Describe appropriate patient preparation
  • Identify and discuss available diagnostic and therapeutic alternatives


  • Recognize common pathological findings and apply appropriate diagnostic and therapeutic interventions
  • Demonstrate the process of endoscope navigation, tip deflection and torque
  • Demonstrate the technique of colonoscope loop reduction
  • Demonstrate the technique for retroflexion
  • Demonstrate the ability to adequately evaluate the mucosa and the skill to target lesions endoscopically
  • Demonstrate improved motor skills and dexterity that form the fundamental basis for the performance of upper and lower endoscopy

Why take the FES exam?

Surgeons are increasingly required to document their competency. FES gives you the opportunity to assess and document your knowledge and skills before it’s required of you.

FES is useful in evaluating whether or not you possess the basic knowledge and skills required to perform gastrointestinal endoscopic surgery.

Many surgeons who were already practicing during the advent of the endoscopic revolution learned basic information and skills that were still a “work in progress.”

Please visit the FES website to purchase a voucher and schedule your exam through the online WebAssessor Scheduling System.

Fundamentals Use of Surgical Energy (FUSE)

FUSE is an educational program comprised of an interactive, multimedia didactic curriculum and an online multiple choice cognitive exam. The program is designed to test your knowledge of safely using surgical, energy-based devices in the OR, endoscopic suite and other procedural areas.

The FUSE didactic materials and exam are designed to inform and promote best practices for the use of electrosurgical, ultrasonic and other energy sources in the OR. You will be able to better understand how energy devices work, when to apply them, and what possible hazards and errors can occur. FUSE is also CME accredited.

Learning objectives:

  • Fundamentals of electrosurgery
  • Mechanisms and prevention of adverse events
  • Monopolar devices
  • Bipolar devices
  • Radiofrequency for soft tissue ablation
  • Endoscopic devices
  • Ultrasonic energy devices
  • Microwave energy systems
  • Energy devices in pediatric surgery
  • Integration of energy systems with implanted cardiac devices
  • Prevention of OR fires

Why take the FUSE exam?

The SAGES’ Resident and Postgraduate Education Committees has noted a dramatic rise in the number and complexity of energy devices for procedural applications, including radio-frequency based systems (e.g., bipolar devices, argon beam, radiofrequency-ablation) and ultrasonic energy systems. These devices often facilitate complex procedures and remain at the core of many innovations in image-guided interventions and surgery, including minimally invasive, general, hepatobiliary, urologic, gynecologic and endoscopic. It is difficult to imagine modern surgery without energy devices, yet despite their frequent use, they remain poorly understood. Devices can result in complications due to the combination of electrical current, heat generation and complex environments.

Please visit the FUSE website to purchase a voucher and schedule your exam through the online WebAssessor Scheduling System.

FES/FUSE Calendar