KOKEN LM-107A User manual

9999
Small Intestine for
Colonoscopy
(semi-di󱐰cult type)
Small Intestine for
Colonoscopy
(easy type)
LM-107A
LM-107B
Instruction Manual
Thank you for purchasing the Small Intestine 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-1-1022-1-01-00

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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-107A Small intestine for Colonoscopy (semi-di󱐰cult type)/LM-107B Small intestine for
Colonoscopy (easy type)
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 “2-2: Applying lubricant jelly” on page 14. 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.

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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HowtochangeSmallIntestineforColonoscopy
 2-2Applyinglubricantjelly

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①
②
③
④
―
―
①
④
③
②
Name Quantity
Small Intestine for Colonoscopy 1
Intestinal sheet 1
Sponge for lubricant application 1
Round stoppers 5
DVD version of Instruction Manual 1
Instruction Manual (this booklet) 1
1. Components and Confi guration
* The Small Intestine for Colonoscopy with
white elastic cords is easy type and that with
yellow elastic cords is semi-di󱐰 cult type.
[Caution]
A simulated polyp cannot be attached to the ascending colon when Small Intestine for Colonoscopy
(this product) is attached to the Colonoscopy Simulator Type II.

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2. Handling Methods
2-1HowtochangeSmallIntestineforColonoscopy
* The same method applies to both easy and semi-di󱐰cult types of the product.
1) Place the rectum/sigmoid colon in the direction shown in the illustration, below.
*Thisistheoverheadviewoftherectum/sigmoidcolonattachedtothemainunit.
*Besuretoinstalltherectum/sigmoidcolonintothemainunitinthisdirection.
2) Insert the ange of the rectum/sigmoid colon into the ange plate.
3) Place the intestinal sheet in the correct direction as shown in the illustration below.
Flange
Intestinal sheet

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*Notethattheintestinalsheetisnotbilaterallysymmetric.
Whentherectum/sigmoidcoloniscoveredwiththeintestinalsheet,thepositionsofthesheetand
thecolonshouldbeasshownintheillustrationbelow.
4) Insert the intestinal sheet between the rectum/sigmoid colon ange and the ange plate.
5) Align the openings of the rectum/sigmoid colon ange and the intestinal sheet with the openings
(the two areas circled in the illustration below) of the ange plate.
Longer
Shorter

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6) Insert the larger screws into the openings.
7) Place the main unit in the direction as shown in the illustration below.
8) Attach the rectum/sigmoid colon flange to the main unit (to the anal side of it) with the larger
screws.

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9) Similarly, attach the two upper areas of the rectum/sigmoid colon ange to the main unit with
the larger screws.
10) Connect the transverse colon to the descending colon and the descending colon to the
rectum/sigmoid colon, and then attach the descending colon to the main unit.
11) Connect the Small Intestine for Colonoscopy to the transverse colon, and install pins at the side
of the main unit into the holes in the holding table.
*Makesuretoalignnotchmarksoneachconnector.
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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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12) Bend the sigmoid colon into an “S” shape to place it in the main unit.
13) Apply a generous amount of powder to the outer surface of the intestine.
* Powder is not included with this product. Use commercially-available powder such as baby powder.
*Beforeusingthemodel,besuretoapplyagenerousamountofpowdertotheoutersurfaceofthe
intestine.Insu󱐰cientapplicationofpowdermayincreasetheintensityofinter-intestinalresistance
andmaketheinsertionofthescopedi󱐰cult.
14) Pass the rst cord from the ascending colon through the opening in the transparent cover of the
main unit and a󱐰x it with a round stopper.
Position of the a󱐰xed
round stopper

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15) Cover the intestine with the intestinal sheet.
16) Insert the small intestine through the opening in the intestinal sheet.
*Passittojustbeforetherstcordfromtheascendingcolonside.
17) Insert the cord of the intestinal sheet through the opening in the transparent cover of the main
unit.
The rst cord from the ascending colon side and its fastener should not be inserted through
the opening of the intestinal sheet.

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18) Pull the cord such that the sheet becomes taut, and a󱐰x it with a round stopper.
19) Insert the second and third cords from the ascending colon side into the openings in the
transparent cover of the main unit and secure them to the cover with round stoppers.
*Insertthecordsonebyone,notbothcordssimultaneously,intheopeningsofthetransparent
coverofthemainunitandtheroundstopper.
*Thelengthfromtheroundstoppertotheendofthe
cordisapproximately8cm.
Approx. 8 cm
Position of the a󱐰xed
round stopper

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20) Insert the fourth and fifth cords from the ascending colon side into the openings in the
transparent cover of the main unit and secure them to the cover with round stoppers.
*Insertthecordsonebyone,notbothcordssimultaneously,intheopeningsofthetransparent
coverofthemainunitandtheroundstopper.
21) Place the model carefully on the sheet so that it does not twist.
*Anypartofthemodel,fromtheopeningsintheintestinalsheettotheendofthesmallintestine,
shouldnotbeplacedatopanyotherpartofthemodel.
Position of the a󱐰xed
round stopper

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22) Insert the round stoppers through the openings in the simulated peritoneal membrane sheet.
*Insertroundstoppersonebyoneintotheopenings.
23) Fasten Velcro tapes on each side of the openings in the simulated peritoneal membrane sheet.
24) Pull the cords of the intestine to align round stoppers with each other.
25) Fasten the other Velcro tapes.
*Pullthecordsfrominsideofthe
simulatedperitonealmembrane
sheetinthedirectionofthearrow
toaligntheroundstopperswiththe
transparentcoverofthemainunit.

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2-2Applyinglubricantjelly
* The same method applies to both easy and semi-di󱐰cult types of the product.
*Beforeusingthemodel,besuretoapplyagenerousamountoflubricantjellytotheinsideofthe
intestine.Insufficientapplicationoflubricantmayincreasetheresistancebetweentheintestine
andthescope/balloonandmaketheinsertionofthescope/balloondi󱐰cult.
*Uselubricantjellythatisspecicallydesignedforballoonendoscopes.
Lubricant should be applied to the following four openings:
1) Pull out the round stoppers through the openings in the simulated peritoneal membrane sheet
and then remove the sheet.
2) Remove the round stoppers for the small intestine.
*Pullthecordsonebyoneinordernottodamagetheirtips.
Anal region
Ascending/transverse colon
connection
Descending/transverse colon
connection
Sigmoid/descending colon
connection

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3) Remove the round stoppers (at the two areas shown in the illustration, below left) from the
intestinal sheet.
4) Remove all the cords from the openings in the transparent cover of the main unit.
5) Insert the small intestine down through the opening in the intestinal sheet.
6) Turn over the intestinal sheet and remove the small intestine from the main unit.

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7) Detach the colon connectors from three points.
8) Soak the sponge provided for lubricant application with lubricant jelly as shown in the illustration below
*Afterapplyinglubricanttoeachpartwiththesponge,thespongeshouldberesaturatedwith
lubricantjelly.
9) Apply lubricant to the small intestine.
*Reapplylubricantjellyintothesmallintestineoneortwomoretimestoensureevendistribution.
• Insert the sponge soaked with lubricant jelly from the ascending colon towards the distal end of the
small intestine while compressing the intestine.
• Gradually pull out the small intestine while squeezing it throughout its length to ensure even
distribution.

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10) Apply lubricant to the ascending colon.
• Squeeze the ascending colon throughout its length to ensure even distribution.
11) Also apply lubricant to the rectum/sigmoid colon, transverse colon, and descending colon as in
the existing models. After lubricant application, reconnect the disassembled colons and install the
intestinal sheet and the simulated peritoneal membrane sheet.