KOKEN Colonoscopy Lower GI Endoscopy Simulator Type... User manual

9999
Colonoscopy
(Lower GI Endoscopy)
Simulator TypeII
LM-107
Instruction Manual
Thank you for purchasing the Colonoscopy(Lower GI Endoscopy) Simulator TypeII.
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-1-1017-1-01-02

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-107 Colonoscopy(Lower GI Endoscopy) Simulator TypeII:
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.

2
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.

3
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.

4
Table of Contents
1.OutlineandFeatures
2.ComponentsandConguration
3.HandlingtheModel
 3-1Howtoapplylubricant
 3-2Howtoassembletheintestine
 3-3Howtoattachsimulatedpolyps(forobservation)
 3-4HowtoattachanoptionalLM-103ASimulatedPolyp(forpolypectomy) 
 3-5Caringfortheproductafteruse
4.Specications
5.OptionalItems(soldseparately)

5
1. Outline and Features
Outline
This training model is used to conrm methods of insertion and orientation for a colonoscope.
Attaching optional parts also enables treatment-related training such as polyp incision and
hemostasis, as well as small intestine insertion training using a balloon endoscope.
Features
1. This product is made with special silicone rubber for a realistic feel and appearance during
observation. Inner content also closely resembles actual biological material.
2. Simulated polyps (for observation) can be attached to the ascending colon and descending
colon for observational purposes.
3. Laterally spreading tumors (LST) are replicated in the ascending colon.
4. Attaching the optional "Simulated Polyps (for polypectomies)" enables various types of
endoscopic treatment-related training as well, such as snare polypectomies, and hemostasis
using a clip.
* Simulated polyps can be attached to ascending and descending colons.
5. Attaching the optional "Small Intestine" enables training such as insertion methods for
double or single balloon enteroscopies, and shortened operations (folding techniques).

6
2. Components and Conguration
Name
1 Main unit
2 Rectum/sigmoid colon part
3 Descending colon part
4 Transverse colon part
5 Ascending colon part
6 Simulated polyps (for observation):
7 Conduction cable
8 Polyp attachment band
9 Flange plate
10 Holding table
11 Simulated peritoneal membrane sheet
12 Screws for ange plate
13 Screws for transparent cover
14 Screw for transverse colon
15 Storage case
- 5 -
2. Components and Configuration
Name
1 Main unit
2 Rectum/sigmoid colon part
3 Descending colon part
4 Transverse colon part
5 Ascending colon part
6 Simulated polyps (for observation):
7 Conduction cable for Simulated Polyps (for polypectomy)
8 Polyp attachment band
9 Flange plate
10 Holding table
11 Simulated peritoneal membrane sheet
12 Screws for flange plate
13 Screws for transparent cover
14 Screw for transverse colon
15 Storage case
3
11
5
6
7
8
9
10
2
4
1
12
13
14
15

7
3. Handling the Model
* Beforeusingthisproduct,besuretoapplyagenerousamountofendoscopelubricanttothe
insideofit.Aninsu󱐰cientamountoflubricantwillincreaseresistancebetweenthescopeand
intestine,makinginsertionmoredi󱐰cult.
*Usealubricantspecicallydesignedforendoscopes.
3-1 Howtoapplylubricant
Lubricant should be applied to the following four openings.
○ Applyinglubricant
1. Remove the simulated peritoneal membrane sheet.
- 6 -
3. Handling the Model
* Before using this product, be sure to apply a generous amount of
endoscope lubricant to the inside of it. An insufficient amount of lubricant
will increase resistance between the scope and intestine, making insertion
more difficult.
* Use a lubricant specifically designed for endoscopes.
3-1 How to apply lubricant
Lubricant should be applied to the following four openings.

Applying lubricant
1. Remove the simulated peritoneal membrane sheet.
Anal
region
Sigmoid/descending
colon connection
Descending/transverse
colon connection
Ascending/transverse
colon connection
- 6 -
3. Handling the Model
* Before using this product, be sure to apply a generous amount of
endoscope lubricant to the inside of it. An insufficient amount of lubricant
will increase resistance between the scope and intestine, making insertion
more difficult.
* Use a lubricant specifically designed for endoscopes.
3-1 How to apply lubricant
Lubricant should be applied to the following four openings.

Applying lubricant
1. Remove the simulated peritoneal membrane sheet.
Anal
region
Sigmoid/descending
colon connection
Descending/transverse
colon connection
Ascending/transverse
colon connection

8
2. Detach colon connectors from these three points.
3. Pull the ascending and descending colons upward to remove them from the main unit.
- 7 -
2. Detach colon connectors from these three points.
3. Pull the ascending and descending colons upward to remove them from the main unit.
- 7 -
2. Detach colon connectors from these three points.
3. Pull the ascending and descending colons upward to remove them from the main unit.

9
4. Apply lubricant to the rectum/sigmoid colon.
Insert lubricant from the anal region as well as the sigmoid colon connector opening. After inserting
a generous amount, squish the intestine together so that the lubricant spreads all the way through it.
5. Apply lubricant to the transverse colon.
Insert lubricant from the splenic and hepatic flexure connector sides. After inserting a generous
amount, squish the intestine together so that the lubricant spreads all the way through it.
6. Apply lubricant to the descending 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.
- 8 -
4. Apply lubricant to the rectum/sigmoid colon.
Insert lubricant from the anal region as well as the sigmoid colon connector opening.
After inserting a generous amount, squish the intestine together so that the lubricant
spreads all the way through it.
5. Apply lubricant to the transverse colon.
Insert lubricant from the splenic and hepatic flexure connector sides. After inserting a
generous amount, squish the intestine together so that the lubricant spreads all the
way through it.
6. Apply lubricant to the descending 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.
Sigmoid colon connector
Splenic flexure side connector
Hepatic flexure side connector
- 8 -
4. Apply lubricant to the rectum/sigmoid colon.
Insert lubricant from the anal region as well as the sigmoid colon connector opening.
After inserting a generous amount, squish the intestine together so that the lubricant
spreads all the way through it.
5. Apply lubricant to the transverse colon.
Insert lubricant from the splenic and hepatic flexure connector sides. After inserting a
generous amount, squish the intestine together so that the lubricant spreads all the
way through it.
6. Apply lubricant to the descending 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.
Sigmoid colon connector
Splenic flexure side connector
Hepatic flexure side connector
- 8 -
4. Apply lubricant to the rectum/sigmoid colon.
Insert lubricant from the anal region as well as the sigmoid colon connector opening.
After inserting a generous amount, squish the intestine together so that the lubricant
spreads all the way through it.
5. Apply lubricant to the transverse colon.
Insert lubricant from the splenic and hepatic flexure connector sides. After inserting a
generous amount, squish the intestine together so that the lubricant spreads all the
way through it.
6. Apply lubricant to the descending 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.
Sigmoid colon connector
Splenic flexure side connector
Hepatic flexure side connector

10
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.
- 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
- 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
- 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

11
2. 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.
3. Align with the polyp attachment band,
- 10 -
2. 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
3. Align with the polyp attachment band,
Polyp attachment band
- 10 -
2. 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
3. Align with the polyp attachment band,
Polyp attachment band

12
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.
- 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
- 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
- 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

13
6. Attach the simulated peritoneal membrane sheet to the main unit.
○ Securingthemodeltothetable
Before using this model, fasten the holding board to a table with belts.
We also recommend placing an absorption sheet under the model to keep the table clean.
Howtoattachxingpins
Attach two xing pins to the holding table to hold the model in place.
- 12 -
6. Attach the simulated peritoneal membrane sheet to the main unit.

Securing the model to the table
Before using this model, fasten the holding board to a table with belts.
We also recommend placing an absorption sheet under the model to keep the table clean.
How to attach fixing pins
Attach two fixing pins to the holding table to hold the model in place.
Absorption sheet
Holding
table
Fixing pins
- 12 -
6. Attach the simulated peritoneal membrane sheet to the main unit.

Securing the model to the table
Before using this model, fasten the holding board to a table with belts.
We also recommend placing an absorption sheet under the model to keep the table clean.
How to attach fixing pins
Attach two fixing pins to the holding table to hold the model in place.
Absorption sheet
Holding
table
Fixing pins
- 12 -
6. Attach the simulated peritoneal membrane sheet to the main unit.

Securing the model to the table
Before using this model, fasten the holding board to a table with belts.
We also recommend placing an absorption sheet under the model to keep the table clean.
How to attach fixing pins
Attach two fixing pins to the holding table to hold the model in place.
Absorption sheet
Holding
table
Fixing pins

14
Howtoattachthemodeltotheholdingtable(dorsalposition)
1. Align holes on the bottom of the main unit with the holding table's xing pins.
2. Run the belts under the table, then fasten their buckles and tighten them down.
Howtoattachthemodeltotheholdingtable(lateralposition)
1. Align holes on the side of the main unit with the holding table's xing pins.
- 13 -
How to attach the model to the holding table (dorsal position)
1. Align holes on the bottom of the main unit with the holding table's fixing pins.
2. Run the belts under the table, then fasten their buckles and tighten them down.
How to attach the model to the holding table (lateral position)
1. Align holes on the side of the main unit with the holding table's fixing pins.
- 13 -
How to attach the model to the holding table (dorsal position)
1. Align holes on the bottom of the main unit with the holding table's fixing pins.
2. Run the belts under the table, then fasten their buckles and tighten them down.
How to attach the model to the holding table (lateral position)
1. Align holes on the side of the main unit with the holding table's fixing pins.
- 13 -
How to attach the model to the holding table (dorsal position)
1. Align holes on the bottom of the main unit with the holding table's fixing pins.
2. Run the belts under the table, then fasten their buckles and tighten them down.
How to attach the model to the holding table (lateral position)
1. Align holes on the side of the main unit with the holding table's fixing pins.

15
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 ange.
- 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
- 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

16

○ Attachingasimulatedpolyptotheascendingcolon
1. Remove the ascending colon from the main unit, insert the selected polyp (for observation) into
the polyp attachment hole, and re-attach the ascending colon to the main unit.
- 15 -
Attaching a simulated polyp to the ascending colon
1. Remove the ascending colon from the main unit, insert the selected polyp (for
observation) into the polyp attachment hole, and re-attach the ascending colon to the
main unit.
Simulated polyp (for observation) in set
position
Intestine

17
3-4HowtoattachanoptionalLM-103ASimulatedPolyp(forpolypectomy)
[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.
○ Attachingthereturnelectrode
1. Use the Velcro on the back of the main unit to attach the conduction cable with the plate side
facing 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.
- 16 -
3-4 How to attach an optional LM-103A Simulated Polyp (for polypectomies)

Attaching the return electrode
1. Use the Velcro on the back of the main unit to attach the conduction cable for
simulated polyps (for polypectomies), with the plate side facing the main unit.
2. Attach a return electrode on hand to cover the conduction cable for simulated polyps
(for polypectomies).
* 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 for
simulated polyps (for polypectomies)
Using one conduction cable Using two conduction cables
Plate side of the conduction cable

18
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.
2. Attach a return electrode on hand to cover the conduction cable for simulated polyps
(for polypectomies).
* When using a dual-type return electrode, attach it so both surfaces are in contact with the plate.
- 16 -
3-4 How to attach an optional LM-103A Simulated Polyp (for polypectomies)

Attaching the return electrode
1. Use the Velcro on the back of the main unit to attach the conduction cable for
simulated polyps (for polypectomies), with the plate side facing the main unit.
2. Attach a return electrode on hand to cover the conduction cable for simulated polyps
(for polypectomies).
* 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 for
simulated polyps (for polypectomies)
Using one conduction cable
Using two conduction cables

19
○ 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.
3. Insert the simulated polyp (for polypectomies) into the descending colon's polyp attachment hole.
- 17 -

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.
3. Insert the simulated polyp (for polypectomies) into the descending colon's polyp
attachment hole, then re-attach the polyp attachment band to cover the flange.
- 17 -

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.
3. Insert the simulated polyp (for polypectomies) into the descending colon's polyp
attachment hole, then re-attach the polyp attachment band to cover the flange.
- 17 -

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.
3. Insert the simulated polyp (for polypectomies) into the descending colon's polyp
attachment hole, then re-attach the polyp attachment band to cover the flange.