K Number
K043594
Device Name
VANGUARD REPROCESSED BLADED TROCAR, NON-BLADED TROCAR, TROCAR ACCESSORIES
Date Cleared
2005-03-31

(92 days)

Product Code
Regulation Number
876.1500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Reprocessed trocars are intended to provide a pathway for entry of instruments during minimally invasive surgery, with particular applications in abdominal, gynecological, urological, and thoracic procedures.
Device Description
A Vanguard Reprocessed Trocar is a previously used device that has been cleaned, inspected, packaged and sterilized by Vanguard Medical Concepts, Inc. Trocar Cannulae are available in sizes 5-15mm inner diameter and 70-100mm length. Cannulae are equipped with a pressure seal for maintenance of pneumopertineum during insertion and withdrawal of instruments. Some models are equipped with a luer stopcock port for insufflation and desufflation of the operative cavity. Some models are provided with stability anchors inserted over the cannula sleeve to help seal the incision site and maintain cavity pressure. Trocar Obturator is available in bladed and non-bladed configurations sized 5-15mm. Bladed models are equipped with a safety shield designed to expose the blade during insertion but to retract over the tip once the operative cavity has been penetrated so as to reduce the risk for vascular or visceral injury. Non-Bladed obturators have either a rounded (blunt) tip or sharply tapered (dilator) tip to allow trocar insertion following a cut down and minimize the risk for internal injury. Vanguard receives previously used trocars from healthcare facilities; cleans, inspects, tests, packages, labels, and sterilizes the devices; and returns them to a healthcare facility for subsequent use.
More Information

Not Found

No
The device description and performance studies focus on the reprocessing of physical surgical instruments (trocars) and do not mention any software, algorithms, or data processing that would indicate the use of AI/ML.

No
The device is used to create a pathway for surgical instruments and maintain cavity pressure, but it does not directly treat or prevent a disease, nor does it restore, correct, or modify a bodily function or structure.

No

A trocar is an instrument used to create a pathway for surgical instruments, not to diagnose a condition. Its function is to provide access during minimally invasive surgery.

No

The device description clearly details physical components (cannulae, obturator, safety shield, stability anchors) and processes involving physical manipulation (cleaning, inspection, packaging, sterilization). There is no mention of software as the primary or sole component.

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

Here's why:

  • Intended Use: The intended use is to "provide a pathway for entry of instruments during minimally invasive surgery." This is a surgical tool used directly on the patient's body.
  • Device Description: The description details the physical components of a surgical trocar (cannulae, obturator) and the reprocessing process. It does not mention any components or processes related to testing samples from the human body.
  • Lack of IVD Characteristics: An IVD device is used to examine specimens derived from the human body (like blood, urine, tissue) to provide information for diagnosis, monitoring, or screening. This device does not perform any such function.

The device is a reprocessed surgical instrument used for accessing the body during surgery, not for in vitro diagnostic testing.

N/A

Intended Use / Indications for Use

Reprocessed trocars are intended to provide a pathway for entry of instruments during minimally invasive surgery, with particular applications in abdominal, gynecological, urological, and thoracic procedures.

Product codes

NLM

Device Description

A Vanguard Reprocessed Trocar is a previously used device that has been cleaned, inspected, packaged and sterilized by Vanguard Medical Concepts, Inc.

Trocar Cannulae are available in sizes 5-15mm inner diameter and 70-100mm length. Cannulae are equipped with a pressure seal for maintenance of pneumopertineum during insertion and withdrawal of instruments. Some models are equipped with a luer stopcock port for insufflation and desufflation of the operative cavity. Some models are provided with stability anchors inserted over the cannula sleeve to help seal the incision site and maintain cavity pressure.

Trocar Obturator is available in bladed and non-bladed configurations sized 5-15mm. Bladed models are equipped with a safety shield designed to expose the blade during insertion but to retract over the tip once the operative cavity has been penetrated so as to reduce the risk for vascular or visceral injury.

Non-Bladed obturators have either a rounded (blunt) tip or sharply tapered (dilator) tip to allow trocar insertion following a cut down and minimize the risk for internal injury.

Vanguard receives previously used trocars from healthcare facilities; cleans, inspects, tests, packages, labels, and sterilizes the devices; and returns them to a healthcare facility for subsequent use.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

abdominal, gynecological, urological, and thoracic

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)

sterilization, packaging validations, and performance and Cleaning, Test Data biocompatibility testing demonstrate that the reprocessed devices perform as intended and are safe and effective. Based upon the information provided herein and the 510(k) "Substantial Conclusion Equivalence" Decision Making Process Chart, we conclude that Vanguard Reprocessed Bladed and Non-Bladed Trocars are substantially equivalent to their legally marketed predicate devices under the Federal Food, Drug and Cosmetic Act.

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

Not Found

Predicate Device(s)

K012539, K963115, K954108, K945457, K931337

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.1500 Endoscope and accessories.

(a)
Identification. An endoscope and accessories is a device used to provide access, illumination, and allow observation or manipulation of body cavities, hollow organs, and canals. The device consists of various rigid or flexible instruments that are inserted into body spaces and may include an optical system for conveying an image to the user's eye and their accessories may assist in gaining access or increase the versatility and augment the capabilities of the devices. Examples of devices that are within this generic type of device include cleaning accessories for endoscopes, photographic accessories for endoscopes, nonpowered anoscopes, binolcular attachments for endoscopes, pocket battery boxes, flexible or rigid choledochoscopes, colonoscopes, diagnostic cystoscopes, cystourethroscopes, enteroscopes, esophagogastroduodenoscopes, rigid esophagoscopes, fiberoptic illuminators for endoscopes, incandescent endoscope lamps, biliary pancreatoscopes, proctoscopes, resectoscopes, nephroscopes, sigmoidoscopes, ureteroscopes, urethroscopes, endomagnetic retrievers, cytology brushes for endoscopes, and lubricating jelly for transurethral surgical instruments. This section does not apply to endoscopes that have specialized uses in other medical specialty areas and that are covered by classification regulations in other parts of the device classification regulations.(b)
Classification —(1)Class II (special controls). The device, when it is an endoscope disinfectant basin, which consists solely of a container that holds disinfectant and endoscopes and accessories; an endoscopic magnetic retriever intended for single use; sterile scissors for cystoscope intended for single use; a disposable, non-powered endoscopic grasping/cutting instrument intended for single use; a diagnostic incandescent light source; a fiberoptic photographic light source; a routine fiberoptic light source; an endoscopic sponge carrier; a xenon arc endoscope light source; an endoscope transformer; an LED light source; or a gastroenterology-urology endoscopic guidewire, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I for the photographic accessories for endoscope, miscellaneous bulb adapter for endoscope, binocular attachment for endoscope, eyepiece attachment for prescription lens, teaching attachment, inflation bulb, measuring device for panendoscope, photographic equipment for physiologic function monitor, special lens instrument for endoscope, smoke removal tube, rechargeable battery box, pocket battery box, bite block for endoscope, and cleaning brush for endoscope. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807of this chapter, subject to the limitations in § 876.9.

0

510(k) Summary of Safety & Effectiveness MAR 3 1 2005

| Submitter | Vanguard Medical Concepts, Inc.
5307 Great Oak Drive
Lakeland, FL 33815 |
|----------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact | Heather Crawford, RAC
Director of Regulatory Affairs
863-683-8680, ext. 249 [voice]
863-683-8703 [facsimile]
hcrawford@safe-reuse.com [email] |
| Date | December 28, 2004 |
| Device | Trade Name: Vanguard Reprocessed Bladed and Non-Bladed Trocars
(US Surgical/AutoSuture Series)
Common Name: Bladed and Non-Bladed Trocar
Classification Number: 21 CFR 876.1500
Classification Name: Endoscope and accessories
Product Code: NLM - Laparoscope, General & Plastic Surgery,
Reprocessed - Class II |
| Predicate
Devices | Original equipment manufacturer (OEM) Bladed and Non-Bladed Trocars are
currently marketed under a variety of trade names. Trade names of current
legally marketed predicate devices are:
US Surgical (AutoSuture) VersaPort™ V2 (5-12mm) Trocar System US Surgical (AutoSuture) VersaPort™ RPF (5-12mm) Trocar System US Surgical (AutoSuture) VersaPort™ RT (5-12mm) Trocar System US Surgical (AutoSuture) BluntPort™ (5-12mm) Trocar System US Surgical (AutoSuture) VersaStep™ (5-12mm) Trocar System US Surgical (AutoSuture) SpringGrip Anchoring Accessory The 510(k) Premarket Notification numbers for these devices are: K012539: VersaStep K963115: Trocar Cannula K954108: Modified VersaPort K945457: Trocar (Accessory) K931337: AutoSuture Dilating Cannula |
| Indications
for Use | Reprocessed trocars are intended to provide a pathway for entry of
instruments during minimally invasive surgery, with particular applications in
abdominal, gynecological, urological, and thoracic procedures. |
| Contra-
indications | Reprocessed trocars should not be used in patients for whom endoscopic
procedure is contraindicated. |
| Device
Description | A Vanguard Reprocessed Trocar is a previously used device that has been
cleaned, inspected, packaged and sterilized by Vanguard Medical Concepts,
Inc. |
| | Trocar Cannulae are available in sizes 5-15mm inner diameter and 70-
100mm length. Cannulae are equipped with a pressure seal for maintenance
of pneumopertineum during insertion and withdrawal of instruments. Some
models are equipped with a luer stopcock port for insufflation and
desufflation of the operative cavity. Some models are provided with stability
anchors inserted over the cannula sleeve to help seal the incision site and
maintain cavity pressure. |
| | Trocar Obturator is available in bladed and non-bladed configurations sized
5-15mm. Bladed models are equipped with a safety shield designed to
expose the blade during insertion but to retract over the tip once the operative
cavity has been penetrated so as to reduce the risk for vascular or visceral
injury. |
| | Non-Bladed obturators have either a rounded (blunt) tip or sharply tapered
(dilator) tip to allow trocar insertion following a cut down and minimize the
risk for internal injury. |
| | Vanguard receives previously used trocars from healthcare facilities; cleans,
inspects, tests, packages, labels, and sterilizes the devices; and returns them to
a healthcare facility for subsequent use. |
| Technological
Characteristics | Vanguard Reprocessed Bladed and Non-Bladed Trocars are essentially
identical to the Original Equipment Manufacturer (i.e., AutoSuture®)
devices. No changes are made to the device materials or specifications and
the reprocessed trocars possess identical technological characteristics. |
| | Continued on next page |

Continued on next page

KO435

BluntPort™, VersaPort™, VersaStep™ and AutoSuture® are registered trademarks of United States Surgical, a division of Tyco Healthcarc

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510(k) Summary of Safety & Effectiveness, Continued

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KO43534 510(k) Summary of Safety & Effectiveness, Continued

sterilization, packaging validations, and performance and Cleaning, Test Data biocompatibility testing demonstrate that the reprocessed devices perform as intended and are safe and effective. Based upon the information provided herein and the 510(k) "Substantial Conclusion Equivalence" Decision Making Process Chart, we conclude that Vanguard Reprocessed Bladed and Non-Bladed Trocars are substantially equivalent to their legally marketed predicate devices under the Federal Food, Drug and Cosmetic Act.

BluntPort™, VersaPort™, VersaStep™ and AutoSuture® are registered trademarks of United States Surgical, a division of Tyco Healthcare

র বি

3

DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular border with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter. Inside the circle is a stylized symbol that resembles a caduceus, with three abstract human profiles facing to the right.

NOV 2 7 2006

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Public Health Service

Ascent Healthcare Solutions % Ms. Moira Barton Regulatory Affairs Manager 10232 South 51st Street Phoenix, Arizona 85044

Re: K043594 - Supplemental Validation Submission Trade/Device Name: See Enclosed List Regulation Number: 21 CRF 876.1500 Regulation Name: Endoscope and accessories Regulatory Class: II Product Code: NLM Dated: March 7, 2005 Received: March 9, 2005

Dear Ms. Barton:

This letter corrects our substantially equivalent letter of March 31, 2005. The above-referenced premarket notification (510(k)) was cleared by the Office of Device Evaluation (ODE) on March 31, 2005. We have received your supplemental validation data as required for reprocessed singleuse devices by the Medical Device User Fee and Modernization Act of 2002. After reviewing your supplemental validation data, we have determined the devices listed in the enclosure accompanying this letter are substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate 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 these devices, 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 devices are classified (see above) into either class II (Special Controls) or class III (PMA) they 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 devices 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 devices comply 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 applicable requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements

4

Page 2 - Ms. Moira Barton

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.

The FDA finding of substantial equivalence of your devices to legally marketed predicate devices results in classification for your devices and thus, permits you to legally market the devices. This letter will allow you to continue marketing the devices listed in the enclosure accompanying this letter.

If you desire specific advice for your devices on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at 240-276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html.

Sincerely wours,

Mark N. Mel kerson Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

5

Page 3 - Ms. Moira Barton

Indications for Use

510 (k) Number (if known) : K043594

Vanguard Reprocessed Bladed and Non-Bladed Trocars Device Name:

Indications For Use:

Reprocessed trocars are intended to provide a pathway for entry of instruments during minimally invasive surgery, with particular applications in abdominal, gynecological, urological, and thoracic procedures.

Prescription Use (Part 21 CFR 801 Subpart D) AND / OR

Over-The-Counter Use (21 CFR 807 Subpart C)

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

evice Evaluation (ODE) Concurrence of CDRH, Offic

estoral e and Neurological

510(k) Nr

6

Page 4 – Ms. Moira Barton

List of Models:

US Surgical (AutoSuture)VersaPort™ V2 (5-12 mm) Trocar System US Surgical (AutoSuture)VersaPort™ RPF (5-12 mm) Trocar System US Surgical (AutoSuture)VersaPort™ RT (5-12 mm) Trocar System US Surgical (AutoSuture)BluntPort™ (5-12 mm) Trocar System US Surgical (AutoSuture)VersaStep™ (5-12 mm) Trocar System US Surgical (AutoSuture) SpringGrip Anchoring Accessory