K Number
K013680
Device Name
CARBODISSECTING ENDOSCOPE
Date Cleared
2002-03-04

(117 days)

Product Code
Regulation Number
878.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
To gently dissect planes of soft tissue using controlled bursts of CO2 gas. The device may be used in both open and endoscopic procedures in which gentle, blunt dissection of soft tissue planes is desired.
Device Description
The Carbodissecting Endoscope consists of two components: The Spatula is a surgical tool used in combination with CO2 and saline, and is designed to be used with the supplied Scope to provide accurate visual feedback during a carbodissection procedure. The tip allows the surgeon to slide between the tissue planes. The front of the tip is slightly curved and has multiple CO2 outlets. The multiple CO2 outlets are used to fan the gas out along the entire front of the tip to help peel apart the two layers, to aid in the separation of the tissue The Scope is a flexible fiberscope intended for use with the Spatula.
More Information

Not Found

No
The device description and intended use focus on mechanical dissection using CO2 gas and visual feedback via a fiberscope. There is no mention of AI, ML, image processing, or any data-driven decision-making components.

No
The device is used for surgical dissection, which is an interventional procedure rather than a therapeutic one designed to treat a disease or condition.

No
Explanation: The Intended Use and Device Description clearly state that the device is used for dissection and separation of soft tissue planes using CO2 gas, not for diagnosing any condition.

No

The device description clearly outlines two physical components: a Spatula and a Scope, which are hardware.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is to "gently dissect planes of soft tissue using controlled bursts of CO2 gas" during surgical procedures (open and endoscopic). This is a surgical tool used directly on the patient's tissue.
  • Device Description: The description details a surgical spatula and an endoscope used for visualization during the dissection process. This further confirms its role as a surgical instrument.
  • Lack of IVD Characteristics: IVD devices are used to examine specimens (like blood, urine, tissue samples) outside of the body to provide information about a person's health. This device does not perform any such analysis of specimens.

The device is clearly designed for in vivo use (within the living body) for surgical dissection, not for in vitro diagnostic testing.

N/A

Intended Use / Indications for Use

To gently dissect planes of soft tissue using controlled bursts of CO2 gas. The device may be used in both open and endoscopic procedures in which gentle, blunt dissection of soft tissue planes is desired.

Product codes

GCJ

Device Description

The Carbodissecting Endoscope consists of two components:

The Spatula is a surgical tool used in combination with CO2 and saline, and is designed to be used with the supplied Scope to provide accurate visual feedback during a carbodissection procedure. The tip allows the surgeon to slide between the tissue planes. The front of the tip is slightly curved and has multiple CO2 outlets. The multiple CO2 outlets are used to fan the gas out along the entire front of the tip to help peel apart the two layers, to aid in the separation of the tissue

The Scope is a flexible fiberscope intended for use with the Spatula.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Not Found

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

Sobel-Kaplitt-Sawyer Gas Spatula, Cook Urological CO2 Pneumo-Dissector, Guidant Corporation Origin Medsystems VasoView Balloon Dissection System

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.4400 Electrosurgical cutting and coagulation device and accessories.

(a)
Identification. An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current.(b)
Classification. Class II.

0

Image /page/0/Picture/1 description: The image is a black and white logo for the U.S. Department of Health & Human Services. The logo features a stylized caduceus symbol, which is a staff with two snakes coiled around it. The caduceus is enclosed within a circle, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is written around the perimeter of the circle. The text is in all capital letters and is arranged in a circular fashion to match the shape of the logo.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

4 2002 MAR

Endo Surgical Devices, Inc. c/o Debbie Iampietro. ORC Consulting 7 Tiffany Trail Hopkinton, Massachusetts 01748

Re: K013680

Trade Name: Carbodissecting Endoscope Regulation Number: 876.1500 Regulation Name: Laparoscope, General and Plastic Surgery Regulatory Class: II Product Code: GCJ Dated: February 6, 2002 Received: February 11, 2002

Dear Ms. Iampietro:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

1

Page 2 - Ms. Debbie Iampietro

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 21 CFR Part 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at (301) 594-4659. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Miriam C Provost

(ar Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Endo Surgical Devices, Inc. Carbodissecting Endoscope

510(k) Number (if known):

Device Name:


Carbodissecting Endoscope

Indications For Use:

To gently dissect planes of soft tissue using controlled bursts of CO2 gas. The device To gently dissect planes of soft trisue using controlled button of of 5-1-2
may be used in both open and endoscopic procedures in which gentle, blunt dissection of soft tissue planes is desired.

(PLEASE DO NOT WRITE BELOW THIS LINE. CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

L Prescription Use (Per 21 CFR 801.109)

Over-The-Counter Use

Mark A. Millican

OR

Division Sign-Off) Division of General, Restorative and Neurological Devices

510(k) Number K013680

000010

3

Ko13680

Endo Surgical Devices, Inc. Carbodissecting Endoscope

Premarket Notification

510K Summary of Safety and Effectiveness

    1. Sponsor Name Endo Surgical Devices, Inc. 4400 Rte 9 So., Suite 1000 Freehold, NJ 07728 Telephone: 732 409-5151

2. Device Name

Proprietary Name: Carbodissecting Endoscope Common/Usual Name: Endoscope and Accessories Classification Name: : Endoscope and Accessories

  • Identification of Predicate or Legally Marketed Device 3.
    • Sobel-Kaplitt-Sawyer Gas Spatula Becton Dickenson and O Company - Preamendments Device
    • Cook Urological CO2 Pneumo-Dissector O
    • Guidant Corporation Origin Medsystems VasoView Balloon o Dissection System
    1. Device Description

The Carbodissecting Endoscope consists of two components:

The Spatula is a surgical tool used in combination with CO2 and saline, and is designed to be used with the supplied Scope to provide accurate visual feedback during a carbodissection procedure. The tip allows the surgeon to slide between the tissue planes. The front of the tip is slightly curved and has multiple CO2 outlets. The multiple CO2 outlets are used to fan the gas out along the entire front of the tip to help peel apart the two layers, to aid in the separation of the tissue

The Scope is a flexible fiberscope intended for use with the Spatula.

  • న్. Intended Use
    To gently dissect planes of soft tissue using controlled bursts of CO2 gas. The device may be used in both open and endoscopic procedures in which gentle, blunt dissection of soft tissue planes is desired.

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