K Number
K053200
Device Name
GORE SEAMGUARD STAPLE LINE REINFORCEMENT MATERIAL
Date Cleared
2005-12-07

(21 days)

Product Code
Regulation Number
878.3300
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The GORE SEAMGUARD Staple Line Reinforcement Material for Circular Staplers is indicated for use in surgical procedures in which a soft tissue anastomosis with staple line reinforcement is needed. GORE SEAMGUARD® Bioabsorbable Staple Line Reinforcement Material can be used for reinforcement of staple lines during bariatric, colon, colorectal, gastric, and small bowel procedures.
Device Description
The GORE SEAMGUARD® Bioabsorbable Staple Line Reinforcement Material for circular staplers consists of a bioabsorbable membrane comprosed of a microporous structure of synthetic bioabsorbable glycolide and trimethylene carbonate copolymer. The GORE SEAMGUARD® Bioabsorbable Staple Line Reinforcement Material is to be used with surgical stapling devices. The GORE SFAMGUARD® Bioabsorbable Staple Line Reinforcement Material is supplied in sterile polyethylene terphthalate / polyethylenc pouches. These pouches contain the necessary material for the cartridge jaw and the anvil jaw of the surgical stapler.
More Information

Not Found

No
The summary describes a bioabsorbable material for staple line reinforcement and does not mention any software, algorithms, or data processing that would indicate the use of AI/ML.

No
The device is a reinforcement material used in surgical stapling procedures, not a therapeutic device designed to treat or cure a disease.

No

Explanation: The device description and intended use clearly state that it is a surgical reinforcement material used during stapling procedures, not for diagnosis.

No

The device description clearly states it is a bioabsorbable membrane material used with surgical staplers, which is a physical component, not software.

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

Here's why:

  • Intended Use: The intended use is for surgical procedures to reinforce staple lines in soft tissue anastomoses. This is a direct surgical intervention on the patient's body.
  • Device Description: The device is a bioabsorbable material used with surgical staplers. It is a physical implant/reinforcement.
  • Lack of Diagnostic Function: There is no mention of the device being used to examine specimens (like blood, tissue, urine, etc.) outside of the body to provide information for diagnosis, monitoring, or screening.

IVD devices are used in vitro (outside the body) to analyze samples and provide diagnostic information. This device is used in vivo (inside the body) during surgery.

N/A

Intended Use / Indications for Use

Indicated for use in surgical procedures in which a soft tissue anastomosis with staple linc reinforcement is needed. GORE SEAMGUARD® Bioabsorbable Staple Line Reinforcement Material can be used for reinforcement of staple lines during bariatric, colon, colorectal, gastric, and small bowel procedures.

Product codes

FTL

Device Description

The GORE SEAMGUARD® Bioabsorbable Staple Line Reinforcement Material for circular staplers consists of a bioabsorbable membrane comprosed of a microporous structure of synthetic bioabsorbable glycolide and trimethylene carbonate copolymer. The GORE SEAMGUARD® Bioabsorbable Staple Line Reinforcement Material is to be used with surgical stapling devices.

The GORE SFAMGUARD® Bioabsorbable Staple Line Reinforcement Material is supplied in sterile polyethylene terphthalate / polyethylenc pouches. These pouches contain the necessary material for the cartridge jaw and the anvil jaw of the surgical stapler.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

soft tissue anastomosis, bariatric, colon, colorectal, gastric, and small bowel

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

Not Found

Key Metrics

Not Found

Predicate Device(s)

K043056

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 878.3300 Surgical mesh.

(a)
Identification. Surgical mesh is a metallic or polymeric screen intended to be implanted to reinforce soft tissue or bone where weakness exists. Examples of surgical mesh are metallic and polymeric mesh for hernia repair, and acetabular and cement restrictor mesh used during orthopedic surgery.(b)
Classification. Class II.

0

053200 1/2

DEC 7 2005

Premarket Notification 510(k) Summary

Applicant:

W.L. Gore and Associates Inc. 3250 W. Kiltic Lane Flagstaff, AZ 86001

Contact:

Michael E. Ivey

Date Prepared:

November 15, 2005

Trade or Proprietary Name:

SEAMGUARD® Staple Line Reinforccment Material

Common or Usual Name:

Staple Line Reinforcement Matcrial

Classification

21 CFR 878.3300, FTL

Device Predicate:

SEAMGUARD® Staple Line Reinforcement Material - K043056

Device Description:

The GORE SEAMGUARD® Bioabsorbable Staple Line Reinforcement Material for circular staplers consists of a bioabsorbable membrane comprosed of a microporous structure of synthetic bioabsorbable glycolide and trimethylene carbonate copolymer. The GORE SEAMGUARD® Bioabsorbable Staple Line Reinforcement Material is to be used with surgical stapling devices.

The GORE SFAMGUARD® Bioabsorbable Staple Line Reinforcement Material is supplied in sterile polyethylene terphthalate / polyethylenc pouches. These pouches contain the necessary material for the cartridge jaw and the anvil jaw of the surgical stapler.

1

Statement of Intended Use:

Indicated for use in surgical procedures in which a soft tissue anastomosis with staple linc reinforcement is needed. GORE SEAMGUARD® Bioabsorbable Staple Line Reinforcement Material can be used for reinforcement of staple lines during bariatric, colon, colorectal, gastric, and small bowel procedures.

Substantial Equivalence:

A variety of tests, assessments, and comparisons demonstrate that the SEAMGUARD* Staple Line Reinforcement Material for Circular Staplers is substantially equivalent to its predicate in terms of composition, design, intended use, mode of operation and performance attributes.

2

Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health and Human Services. The logo features a stylized eagle with three lines forming its body and head. The eagle is positioned to the right of a circular border containing the text "DEPARTMENT OF HEALTH AND HUMAN SERVICES . USA" in all capital letters. The text is arranged around the circumference of the circle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

DEC 7 2005

Michael Ivey Regulatory Affairs Medical Products Division W.L. Gore & Associates, Inc. 3450 West Kiltie Lane Flagstaff, Arizona 86003-2400

Re: K053200

K033200
Trade/Device Name: GORE SEAMGUARD® Staple Line Reinforcement Material for Circular Staplers Regulation Number: 21 CFR 878.3300 Regulation Name: Surgical mesh Regulatory Class: II Product Code: FTL Dated: November 15, 2005 Received: November 16, 2005

Dear Mr. Ivey:

We have reviewed your Section 510(k) premarket notification of intent to market the indication We have reviewed your Section 910(t) premained in substantially equivalent (for the indications
referenced above and have determined the device is substantial in interstate referenced above and nave determined the devices marketed in interstate
for use stated in the enclosure) to legally marketed predical Desine Amendments for use stated in the encrosure) to regary manced promoted provice Amendments, or to
commerce prior to May 28, 1976, the enactment date of the Edical Federal Food. Drug commerce prior to May 20, 1970, the chassified in accordance with Federal Food, Drug, devices that have been reclassified in accordance was a premarket approval application (PMA).
and Cosmetic Act (Act) that do not require approval of a provisions of the Act. and Cosment Act (Act) that do not require approval controls provisions of the Act. The
You may, therefore, market the device, subject to the general controls provisions of Y ou may, meretore, market the dovice, basject to annual registration, listing of
general controls provisions of the Act include requirements for annual registmenting ond general controls provisions of the Feet mendes required.
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 If your device is classified controls. Existing major regulations affecting your device can
may be subject to such additional controls. Existing major regulations affective may be subject to such adultional controlis. Little 21, Parts 800 to 898. In addition, FDA may
be found in the Code of Federal Regulations, Title 21, Parts 800 to 898, star be found in the Code of Pouchal 2015erning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination doss not mean Please be advised that FDA s issuation of a cases in the requirements of the Act
that FDA has made a determination that your device complies with other requirements of the Ac that FDA has made a decemmanon this Jour assert by other Federal agencies. You must a or any Federal statutes and regulations daminities or registration and listing (21
comply with all the Act's requirements, including, but not limited to: registraments as set CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as setting CFR Part 807), labeling (21 CFR Part 820); and if applicable, the electronic form in the quanty systems (QD) regalizers (Sections 531-542 of the Act); 21 CFR 1000-1050.

3

Page 2-Michael Ivey

This letter will allow you to begin marketing your device as described in your Section 510(k) This letter will anow you to ogin manieting of substantial equivalence of your device to a legally premaired notheation: "The Pro Pro mailing sitication 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), please If you desire specific advice 101-your 2001) 276-0115. Also, please note the regulation entitled, Contact the Orition of Computers on (21CFR Part 807.97). You may obtain Misoraning Uy reference to premainsmonibilities under the Act from the Division of Small other general information on your response Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

farbay Buellmp

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

Enclosure

4

Indications for Use

510(k) Number (if known): K053200

Device Name: GORE SEAMGUARD® Staple Line Reinforcement Material

for Circular Staplers

Indications for Use:

The GORE SEAMGUARD Staple Line Reinforcement Material for Circular Staplers is indicated for use in surgical procedures in which a soft tissue anastomosis with staple line reinforcement is needed. GORE SEAMGUARD® Bioabsorbable Staple Line Reinforcement Material can be used for reinforcement of staple lines during bariatric, colon, colorectal, gastric, and small bowel procedures.

Prescription Use X (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use (21 CFR 801 Subpart C)

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

hase Buehum

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

510(k) Number K053200