Ascending Colon forColonoscopy
LM-107C

Descending Colon forColonoscopy
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 JAPANURL:http://www.kokenmpc.co.jp
E-mail:customer@kokenmpc.co.jp 								9999C-1-1023-1-01-01

Handling and Safety Precautions
These precautions should be strictly observed to ensure safe, long-term use ofthe 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 biologicalmaterial.
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 insufficient 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 tofade or deform its shape.
5. Do not use oil-based inks, pencils, chalks, or paints on this product as they may cause permanentstaining.
6. When transporting this product in its storage case, make sure the metal latches are closed. Also, if thestorage 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 ahigh temperature and always store in a refrigerator (between 2 and 10ºC, do not freeze). If it is stored at atemperature 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.

1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 (forpolypectomy).
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 ofthe product.
Caring for the model after use
1. After using this product, thoroughly flush 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 watereddown,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 todeform or degrade. When not in use, keep it in the storage case in a flat 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 ofthis instruction manual.
4. This product should be used only as described in this instruction manual. In particular, the productshould 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 Configuration
2. Handling Methods
2-1 Changing parts of the intestinal tract2-1-1 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 Conﬁguration
Ascending Colon for Colonoscopy parts

Descending Colon for Colonoscopy parts

Common parts⑥ Left ⑦ Right♦ Descending Colon for Colonoscopy parts♦ Common parts[6] Left; [7] Right①②③④⑤⑥⑦⑧‒

NameQuantity
Ascending Colon for Colonoscopy
1Spacers for pins 16 mm
2
Descending Colon for Colonoscopy
1Spacers for pins 10 mm
2
Simulated polyp attachment band
1
Sessile polyp for observation
1
Pedunculated polyp for observation1
Velcro with double-faced adhesive tape2
Instruction Manual (this booklet)
1

P.5
5
2. Handling Methods
2-1 Changing parts of the intestinal tract

2. Handling Methods
2-1 Changing parts of the intestinal tract2-1-1 How to change Ascending Colon for Colonoscopy
1) Remove the round stoppers for the simulated peritoneal membrane sheet, small intestine, andintestinal 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 thesheet.

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 twoscrews, 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

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Transverse colon anddescending colon

Rectum/sigmoid colonand descending colon

Make tosureto alignmarks
on each* Make* surealignnotchmarks
onconnector
each connector.

FemaleMale- 9 - colon’s seat into the pins to attach the ascending7) As shown below, push holes in the ascending
colon to the main unit.

82-1-2 How to change Descending Colon for Colonoscopy
1) Remove the round stoppers for the simulated peritoneal membrane sheet, small intestine, andintestinal 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.

94) Remove the two screws affixing 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 twoscrews, 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 (10 mm)
ピン用スペーサー10mm	 6) Connect the Descending Colon to the rectum/sigmoid colon and transverse colon.

Rectum/sigmoid colon and Descending ColonTransverse colon and Descending Colon

10Ascending colon andtransverse colon       * Make sure to align notch on each connector* Make sure to align notch marks on each connector.
FemaleMale

5. As shown below, push holes in the ascending colon's seat into the pins to attach theascending colon to the main unit.

7) Connect the polyp attachment band to the pin on the upper right section of the main unit, then pushholes in the descending colon’s seat into the pins to attach the descending colon to the main unit.
Polyp attachment band8) Align with the polyp attachment band.

- 11 -

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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

SessilePedunculated

Attach the two pieces of provided Velcro with double-faced adhesive tape to the centralarea (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.

Velcroマジックテープ122-2-1 How to attach a simulated polyp (for observation) to the ascending colon1) Detach the ascending colon from the main unit, and insert a selected simulated polyp (forobservation) into the polyp attachment opening located in the lower part of the ascending colon.
Then, reattach the ascending colon to the main unit.

Intestine

Simulated polyp (for observation) installed132-2-2 How to attach a simulated polyp (for observation) to the descending colon
SessilePedunculated1) Unhook the polyp attachment band around the Descending Colon, and insert a selected simulated Attaching
polyp to theinto
descending
polyp (foraobservation)
the polypcolon
attachment opening. Hook the polyp attachment band so that
1. Remove the polyp attachment band from the descending colon, then insert theit coverssimulated
the flangepolypof the(forsimulated
polyp.
selectedobservation)
into the polyp attachment hole. Next,
re-attach the polyp attachment band to cover the polyp flange.

Polypattachment
Polypattachmentopening
hole

Intestine
Intestine
Simulated
polyp(for(forobservation)observation)installed
in setSimulated
polypposition- 14 -14

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. Insuﬃcient application of lubricant may increase scope-to-intestine resistance andmake the insertion of the scope diﬃcult.
* Use lubricant jelly that is specifically designed for endoscopes.
Lubricant should be applied to the following openings
The connection between the
上行結腸、横行結腸接続
ascendingand transverse colons

部

The connection between the
S 状結腸、下行結腸接続
sigmoidand descending colons

部

The connection between the
下行結腸、横行結腸接続
descending
and transverse colons

部

2-3-1 How to apply lubricant jelly to the ascending colon1) 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.

15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 thetwo 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. Whenusing 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 areavailable as optional accessories if needed for the use of simulated polyps (for polypectomies) inboth the ascending and descending colons.

Velcroplate side of theconduction cable

Using one conduction cable

Using two conduction cables2) 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 thelower illustrations below.
* When using a dual-type return electrode, attach it so both surfaces are in contact with the plate.

Using one conduction cable

Using two conduction cables17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 theascending colon, and reattach the ascending colon to the main unit.

184 ) Position the conduction cable between two pieces of Velcro as shown in the left illustration
below, and reattach the simulated peritoneal membrane sheet.

Velcro tapes

Intestine

Conduction cable ring

Main unit

Simulated polyp (for polypectomies) installed

2-4-2 Attaching a simulated polyp (for polypectomies) to the descending colon1) Remove the simulated peritoneal membrane sheet, then remove the polyp attachment bandfrom the descending colon.

2) Insert a simulated polyp (for polypectomies) into the conduction cable’s metal ring.

19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.

Polyp attachment band

Conduction cable ringIntestine

Simulated polyp (for polypectomies) in set4) Position the conduction cable between the Velcro and re-attach the simulated peritoneal
membrane sheet.

Velcro203, Optional items (sold separately)
Product nameProduct No.

1 Small intestine for Colonoscopy (semi-difficult type)LM-107A

2 Small intestine for Colonoscopy (easy type)LM-107B

3 Ascending Colon for Colonoscopy

LM-107C

4 Descending Colon for Colonoscopy

LM-107D

5 Conduction cable

LM-107E

6 Simulated Polyp (for polypectomy): 5 countLM-103A※ Pedunculated only.
※ Refrigeration is required for this product (store between 2 and 10 deg. C, do not freeze).

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