KOKEN LM-107C User manual

9999
Ascending Colon for
Colonoscopy
Descending Colon for
Colonoscopy
LM-107C
LM-107D
Instruction Manual
Thank you for purchasing the Ascending/Descending Colon for Colonoscopy.
Please read this instruction manual carefully to ensure correct use of the product,
and store it in a safe place for easy access.
KOKEN CO., LTD.
1-4-14 Koraku, Bunkyo-ku, Tokyo 112-0004 JAPAN
URL:http://www.kokenmpc.co.jp
E-mail:[email protected] C-1-1023-1-01-01

1
Handling and Safety Precautions
These precautions should be strictly observed to ensure safe, long-term use of
the product.
The following precautions should be especially adhered to:
○Regarding the LM-107C Ascending Colon for Colonoscopy/ LM-107D Descending Colon for Colonoscopy
1. This product is made with special silicone rubber to simulate the texture of human skin, and excessive
force may damage the products. So we recommend that it be handled as carefully as actual biological
material.
2. Before using this product, be sure to apply a generous amount of endoscope lubricant to the inside of it.
For details, refer to "3-1: How to apply lubricant" on page 6. An insu󱐰cient amount of lubricant may cause
the endoscope to get stuck inside of the model, which could possibly break it.
3. Do not place objects on the main unit, as doing so may alter its shape.
4. Do not use thinner, benzine or other organic solvents on this product. Doing so may cause its color to
fade or deform its shape.
5. Do not use oil-based inks, pencils, chalks, or paints on this product as they may cause permanent
staining.
6. When transporting this product in its storage case, make sure the metal latches are closed. Also, if the
storage case is tilted or experiences heavy shock, the case or model may break as a result.
Optional Items (sold separately)
○ Regarding the "LM-103A Simulated Polyp (for polypectomy)":
1. Please take care to follow the directions below so as to avoid mold growth or degeneration of the
Simulated Polyp.
1-1. Please avoid storing the Simulated Polyp (for polypectomy) at a location with direct sunlight or a
high temperature and always store in a refrigerator (between 2 and 10ºC, do not freeze). If it is stored at a
temperature of over 30ºC, it may change in shape or degrade, rendering it unusable.
1-2. Please use the Simulated Polyp as early as possible after it has been unsealed. KOKEN is not
responsible for quality of Simulated Polyps that have already been unsealed.
1-3. When taking out the Simulated Polyp, please use clean tweezers etc.
1-4. If a Simulated Polyp has been taken out of the container, please do not put it back in the container.
1-5. Do not leave a Simulated Polyp (for polypectomy) out of the container for a long period of time.
The surface will become dry and hard, and it will not be possible to use it any longer.

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1-6. Always store in the storage liquid. Storing it in other liquids will cause degeneration of the polyp.
Be careful not to spill the storage liquid or throw it away before using all the Simulated Polyps (for
polypectomy).
2. When resecting a Simulated Polyp (for polypectomy), always use a disposable electrode.
3. Be sure that no storage liquid gets in your eyes or mouth.

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Handling and Safety Precautions
These precautions should be strictly observed to ensure safe, long-term use of
the product.
Caring for the model after use
1. After using this product, thoroughly ush out the lubricant with cold or hot water.
2. To clean the storage case, wipe with gauze or similar material moistened with water or a watered-
down,mild detergent.
* Do NOT use thinner, benzine, or other solvents to clean the storage case.
3. Keeping this product in direct sunlight or exposed to UV light for a long period of time may cause it to
deform or degrade. When not in use, keep it in the storage case in a at area away from direct sunlight or
UV light.
1. The contents of this instruction manual are subject to change without notice.
2. This instruction manual may not be reproduced in part or in its entirety without permission.
3. Please contact the manufacturer in the event that any errors or omissions are found in the contents of
this instruction manual.
4. This product should be used only as described in this instruction manual. In particular, the product
should not be used in any way that contravenes the precautions noted in the instruction manual.

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Table of Contents
1. ComponentsandConguration
2. HandlingMethods
 2-1Changingpartsoftheintestinaltract
  2-1-1HowtochangeAscendingColonforColonoscopy
  2-1-2HowtochangeDescendingColonforColonoscopy
 2-2Attachingasimulatedpolyp(forobservation)
  2-2-1Howtoattachasimulatedpolyp(forobservation)totheascendingcolon

 2-2-2Howtoattachasimulatedpolyp(forobservation)tothedescendingcolon 
 2-3Applyinglubricantjelly
  2-3-1Howtoapplylubricantjellytotheascendingcolon
  2-3-2Howtoapplylubricantjellytothedescendingcolon
 2-4Attachingsimulatedpolyps(forpolypectomies)

2-4-1Howtoattachasimulatedpolyp(forpolypectomies)totheascendingcolon
  2-4-2Howtoattachasimulatedpolyp(forpolypectomies)tothedescendingcolon
3. OptionalItems

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1. Components and Confi guration
Ascending Colon for Colonoscopy parts
Descending Colon for Colonoscopy parts
Common parts
⑥ Left ⑦ Right
- 2 -
♦ Descending Colon for Colonoscopy parts
♦ Common parts
[6] Left; [7] Right
Name Quantity
① Ascending Colon for Colonoscopy 1
② Spacers for pins 16 mm 2
③ Descending Colon for Colonoscopy 1
④ Spacers for pins 10 mm 2
⑤ Simulated polyp attachment band 1
⑥ Sessile polyp for observation 1
⑦ Pedunculated polyp for observation 1
⑧ Velcro with double-faced adhesive tape 2
‒ Instruction Manual (this booklet) 1
P.5
2. Handling Methods
2-1 Changing parts of the intestinal tract
2-1-1 How to change Ascending Colon for Colonoscopy
1) Remove the round stoppers for the simulated peritoneal membrane sheet, small
intestine, and intestinal sheet.
2) Remove screws from the transparent cover and lift off the cover.
3) Insert the small intestine through the opening in the intestinal sheet, and then
turn over the sheet.
P.6
4) Remove the two screws affixing the ascending colon to the main unit, using a
screwdriver. *A screwdriver is not included with the product.
5) Remove the ascending colon. Install the provided spacers for pins (16 mm) to the
above two screws, and tighten the screws at the two points shown in the
illustration, below.
* For the rest of this document, the two screws will be referred to as “pins.”
Spacers for pins (16 mm)
6) Connect the ascending colon to the transverse colon.
Ascending colon and transverse colon
P7
Make sure to align marks on each connector
Male Female
7) As shown below, push holes in the ascending colon’s seat into the pins to attach
the ascending colon to the main unit.

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2. Handling Methods
2-1Changingpartsoftheintestinaltract
2-1-1 How to change Ascending Colon for Colonoscopy
1) Remove the round stoppers for the simulated peritoneal membrane sheet, small intestine, and
intestinal sheet.
2) Remove screws from the transparent cover and lift off the cover.
3) Insert the small intestine through the opening in the intestinal sheet, and then turn over the
sheet.

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4) Remove the two screws a󱐰 xing the ascending colon to the main unit, using a screwdriver.
* A screwdriver is not included with the product.
5) Remove the ascending colon. Install the provided spacers for pins (16 mm) to the above two
screws, and tighten the screws at the two points shown in the illustration, below.
* For the rest of this document, the two screws will be referred to as “pins.”
6) Connect the ascending colon to the transverse colon.
Spacers for pins (16 mm)
Ascending colon and transverse colon

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*Makesuretoalignmarksoneachconnector
7) As shown below, push holes in the ascending colon’s seat into the pins to attach the ascending
colon to the main unit.
- 9 -
7. Apply lubricant to the ascending colon.
Squeeze lubricant into the intestine. After inserting a generous amount, squish the
intestine together so that the lubricant spreads all the way through it.
3-2 How to assemble the intestine

Assembling the lubricated intestine
1. Reconnect the disassembled descending colon to the rectum/sigmoid colon and
transverse colon.
* Make sure to align notch marks on each connector.
Rectum/sigmoid colon
and descending colon
Transverse colon and
descending colon
Male
Female

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2-1-2 How to change Descending Colon for Colonoscopy
1) Remove the round stoppers for the simulated peritoneal membrane sheet, small intestine, and
intestinal sheet.
2) Remove the screws from the transparent cover and lift off the cover.
3) Insert the small intestine through the opening in the intestinal sheet, and turn over the sheet.

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4) Remove the two screws a󱐰 xing the descending colon to the main unit, using a screwdriver.
*A screwdriver is not included with the product.
5) Remove the descending colon. Install the provided spacers for pins (10 mm) to the above two
screws, and tighten the screws at the two points shown in the illustration, below.
* For the rest of this document, the two screws will be referred to as “pins.”
6) Connect the Descending Colon to the rectum/sigmoid colon and transverse colon.
Rectum/sigmoid colon and Descending Colon Transverse colon and Descending Colon
ピン用スペーサー10mm
Spacers for pins (10 mm)

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- 11 -
4. Reconnect the disassembled ascending colon to the transverse colon.
* Make sure to align notch marks on each connector.
5. As shown below, push holes in the ascending colon's seat into the pins to attach the
ascending colon to the main unit.
Ascending colon and
transverse colon
Male
Female
*Makesuretoalignnotchoneachconnector
7) Connect the polyp attachment band to the pin on the upper right section of the main unit, then push
holes in the descending colon’s seat into the pins to attach the descending colon to the main unit.
8) Align with the polyp attachment band.
Polyp attachment band

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2-2Attachingasimulatedpolyp(forobservation)
Select from the simulated polyps (for observation) below and attach one to a designated area.
Protruding polyps
Sessile Pedunculated
Attach the two pieces of provided Velcro with double-faced adhesive tape to the central
area (near the depressed area) of the back of the main unit, as shown in the illustration
below.
* The Velcro is used when attaching a simulated polyp (for polypectomies) which is an
optional accessory.
* If you have Ascending or Descending Colon for Colonoscopy with Velcro already attached
to it, you do not need to perform the above procedure.
マジックテープ
Velcro

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2-2-1 How to attach a simulated polyp (for observation) to the ascending colon
1) Detach the ascending colon from the main unit, and insert a selected simulated polyp (for
observation) into the polyp attachment opening located in the lower part of the ascending colon.
Then, reattach the ascending colon to the main unit.
- 12 -
Simulated polyp (for observation) installed
Intestine

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2-2-2 How to attach a simulated polyp (for observation) to the descending colon
1) Unhook the polyp attachment band around the Descending Colon, and insert a selected simulated
polyp (for observation) into the polyp attachment opening. Hook the polyp attachment band so that
it covers the ange of the simulated polyp.
- 14 -
3-3 How to attach simulated polyps (for observation)
Select from the simulated polyps (for observation) below and attach them to the
designated areas on the ascending colon and descending colon.

Attaching a polyp to the descending colon
1. Remove the polyp attachment band from the descending colon, then insert the
selected simulated polyp (for observation) into the polyp attachment hole. Next,
re-attach the polyp attachment band to cover the polyp flange.
Variants
PedunculatedSessile
Polyp attachment hole
Simulated polyp (for observation) in set
position
Intestine
Simulated polyp (for observation) installed
Polyp attachment opening
Intestine

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2-3Applyinglubricantjelly
*Beforeusingthemodel,besuretoapplyagenerousamountoflubricantjellytotheinsideof
theintestine.Insufficientapplicationoflubricantmayincreasescope-to-intestineresistanceand
maketheinsertionofthescopedifficult.
*Uselubricantjellythatisspecicallydesignedforendoscopes.
Lubricant should be applied to the following openings
2-3-1 How to apply lubricant jelly to the ascending colon
1) Remove the simulated peritoneal membrane sheet, and detach the colon connector at the point
shown in the right illustration below.
2) Pull the ascending colon upward to remove it from the main unit.
S状結腸、下行結腸接続
部
下行結腸、横行結腸接続
部
上行結腸、横行結腸接続
部
The connection between the
ascending and transverse colons
The connection between the
sigmoid and descending colons
The connection between the
descending and transverse colons

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3) Squeeze lubricant jelly into the intestine. Then, squeeze the intestine along its length to ensure
even distribution.
2-3-2 How to apply lubricant jelly to the descending colon
1) Remove the simulated peritoneal membrane sheet, and detach the two colon connectors at the
two points shown in the right illustration below.
2) Pull the Descending Colon upward to remove it from the main unit.
3) Squeeze lubricant jelly into the intestine. Then, squeeze the intestine along its length to ensure
even distribution.

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2-4Attachingsimulatedpolyps(forpolypectomies)
[Caution]
Besuretodisconnecttheconductioncablefromthemodelwhennotusing(attaching)any
simulatedpolyp(forpolypectomies)inordertoavoidanyelectricalhazards.
1) Attach the plate side of the conduction cable to the Velcro on the back of the main unit. When
using simulated polyps (for polypectomies) in both the ascending and descending colons, you
should attach the two plates side-by-side to the Velcro on the back of the main unit as shown in
the lower right illustration below.
* Note that only one conduction cable is included with this product. Extra conduction cables are
available as optional accessories if needed for the use of simulated polyps (for polypectomies) in
both the ascending and descending colons.
2) Attach a return electrode which you might have to cover the plate of the conduction cable.
When using simulated polyps (for polypectomies) in both the ascending and descending colons,
you should attach the return electrode so that it is in contact with the two plates as shown in the
lower illustrations below.
* When using a dual-type return electrode, attach it so both surfaces are in contact with the plate.
Velcro
plate side of the
conduction cable
Using one conduction cable Using two conduction cables
Using one conduction cable
Using two conduction cables

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2-4-1 How to attach a simulated polyp (for polypectomies) to the ascending colon
1) Remove the simulated peritoneal membrane sheet, and detach the ascending and transverse
colons, while they are still connected, from the main unit.
2) Insert a simulated polyp (for polypectomies) through the ring of the conduction cable.
3) Insert the simulated polyp (for polypectomies) into the polyp attachment opening of the
ascending colon, and reattach the ascending colon to the main unit.

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4 ) Position the conduction cable between two pieces of Velcro as shown in the left illustration
below, and reattach the simulated peritoneal membrane sheet.
2-4-2 Attaching a simulated polyp (for polypectomies) to the descending colon
1) Remove the simulated peritoneal membrane sheet, then remove the polyp attachment band
from the descending colon.
2) Insert a simulated polyp (for polypectomies) into the conduction cable’s metal ring.
Velcro tapes
Conduction cable ring Intestine
Main unit
Simulated polyp (for polypectomies) installed