Fundamentals of Laparoscopic Surgery (FLS) Practice Exam

Stopping warfarin a few days before surgery aims to reduce bleeding risk while keeping the time off anticoagulation reasonable. Warfarin blocks vitamin K–dependent clotting factors and has a long half-life (roughly 36–42 hours), so its effect lingers after the pill is stopped. The INR typically falls toward normal within about three days for many patients, which lowers intraoperative bleeding risk enough for a minimally invasive procedure like laparoscopy without keeping the patient off protection for too long. Stopping earlier (more days) can unnecessarily raise thromboembolism risk, while stopping too late (one or two days) may leave the patient still highly anticoagulated during the operation. If there’s high thrombotic risk, bridging with heparin and individual INR checks may be considered, but three days is the usual preoperative timeframe.