K Number
K071754
Device Name
NEO-VAGINA SURGERY SET AND ACCESSORIES
Date Cleared
2009-01-07

(559 days)

Product Code
Regulation Number
884.3900
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The KSEA Neo-vagina Surgery Set and Accessories is indicated for use by qualified surgeons in women with congenital absence of the vagina who have failed first-line non-surgical treatment with conventional vaginal dilators. The set is used in conjunction with a laparoscopic surgical procedure to create and enlarge the vaginal cavity via continuous traction between the abdomen and vulva, and to maintain the vaginal canal after surgery.
Device Description
The KSEA Neo-vagina Surgery Set and Accessories is indicated for use by qualified surgeons to be placed in the vagina to enlarge the vaginal cavity and maintain the vaginal canal after laparoscopic-assisted creation of a neo-vagina.
More Information

No
The summary describes a surgical device set for creating and maintaining a neo-vagina, with no mention of AI or ML technology in its intended use, device description, or any other section.

Yes
The device is used to create and maintain a vaginal canal in women with congenital absence of the vagina, which is a therapeutic intervention.

No
This device is a surgical set used to create and maintain a neo-vagina, which is a therapeutic rather than a diagnostic function. It does not identify or characterize diseases or conditions.

No

The device description clearly states it is a "Surgery Set and Accessories" and is "placed in the vagina," indicating it is a physical medical device, not software.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are medical devices intended for use in vitro for the examination of specimens derived from the human body in order to provide information for diagnostic, monitoring, or compatibility purposes. This typically involves tests performed on samples like blood, urine, tissue, etc.
  • Device Description and Intended Use: The description clearly states the device is a surgical set and accessories used in vivo (within the body) during and after a surgical procedure to create and maintain a neo-vagina. It is a physical device used for a surgical intervention, not for analyzing biological specimens.

Therefore, the KSEA Neo-vagina Surgery Set and Accessories falls under the category of a surgical device, not an In Vitro Diagnostic.

N/A

Intended Use / Indications for Use

The KSEA Neo-vagina Surgery Set and Accessories is indicated for use by qualified surgeons in women with congenital absence of the vagina who have failed first-line non-surgical treatment with conventional vaginal dilators. The set is used in conjunction with a laparoscopic surgical procedure to create and enlarge the vaginal cavity via continuous traction between the abdomen and vulva, and to maintain the vaginal canal after surgery.

Product codes

HDX

Device Description

The KSEA Neo-vagina Surgery Set and Accessories is indicated for use by qualified surgeons to be placed in the vagina to enlarge the vaginal cavity and maintain the vaginal canal after laparoscopic-assisted creation of a neo-vagina.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

vagina, vaginal cavity, vaginal canal, abdomen, vulva

Indicated Patient Age Range

Not Found

Intended User / Care Setting

qualified surgeons

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)

Bioteque America, Inc. (K003380), Specialities REMEEX International, S.L. (K033310)

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 884.3900 Vaginal stent.

(a)
Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or to support the vagina and to hold a skin graft after reconstructive surgery.(b)
Classification. Class II (performance standards).

0

Image /page/0/Picture/0 description: The image shows the date "JAN - 7 2009" on the left side. To the right of the date is the logo for STORZ, with the words "KARL STORZ ENDOSCOPY" written underneath. The logo is in black and white and has a bold, sans-serif font. The image appears to be a scan or photocopy of a document.

510(K) SUMMARY
Sponsor/Submitter:Karl Storz Endoscopy-America, Inc.
Contact Person:Crystal Dizol
Regulatory Affairs Specialist
Email: cdizol@ksea.com
Date of Submission:June 26, 2007
Device Trade Name:Karl Storz Neo-vagina Surgery Set and Accessories
Common Name:Vaginal Dilator
Classification Name:Vaginal Stent
Regulation Number:21 CFR § 4.3900
Product Code:HDX
Predicate Device(s):Bioteque America, Inc. (K003380)
Specialities REMEEX International, S.L. (K033310)
Device Description:The KSEA Neo-vagina Surgery Set and Accessories is indicated for use by
qualified surgeons to be placed in the vagina to enlarge the vaginal cavity and
maintain the vaginal canal after laparoscopic-assisted creation of a neo-vagina.
Indications for Use:The KSEA Neo-vagina Surgery Set and Accessories is indicated for use by
qualified surgeons in women with congenital absence of the vagina who have
failed first-line non-surgical treatment with conventional vaginal dilators. The set
is used in conjunction with a laparoscopic surgical procedure to create and
enlarge the vaginal cavity via continuous traction between the abdomen and
vulva, and to maintain the vaginal canal after surgery.
Technological
Characteristics:The KSEA Neo-vagina Surgery Set and Accessories and its predicate devices
are removable reusable devices, intended to enlarge the vagina by stretching
and maintain vaginal patency. They are composed of biocompatible and
autoclavable materials and are available in a range of sizes to meet the clinical
and aesthetic needs of each case.
Summary of
Substantial
Equivalence:The KSEA Neo-vagina Surgery Set and Accessories is substantially equivalent
to the predicate device since the basic features, design, and intended uses are
similar. The minor differences between the KSEA Neo-vagina Surgery Set and
Accessories and the predicate devices raise no new issues of safety and
effectiveness, as these design differences have no effect on the performance,
function, or intended use of the devices.

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/1/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three horizontal bars representing its wings. The eagle is enclosed in a circle with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter of the circle. The text is in all capital letters.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

JAN - 7 2009

Ms. Crystal Dizol. Regulatory Affairs Specialist Karl Storz Endoscopy-America, Inc. 600 Corporate Pointe CULVER CITY CA 90230-7600

Re: K071754

Trade/Device Name: KSEA Neo-vagina Surgery Set and Accessories Regulation Number: 21 CFR §884.3900 Regulation Name: Vaginal stent Regulatory Class: II Product Code: HDX Dated: December 29, 2008 Received: December 30, 2008

Dear Ms. Dizol:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indictions 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 the device, subject to the general controls provisions of the The general controls provisions of the Act include requirements for annual registration, including 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.

2

Page 2

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.

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), please contact the Office of Compliance at one of the following numbers, based on the regulation number at the top of this letter:

21 CFR 876.xxx(Gastroenterology/Renal/Urology)240-276-0115
21 CFR 884.xxx(Obstetrics/Gynecology)240-276-0115
21 CFR 894.xxx(Radiology)240-276-0120
Other240-276-0100

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometrics' (OSB's) Division of Postmarket Surveillance at 240-276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at 240-276-3464. 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/industry/support/index.html.

Sincerely vours.

Jozue M. Whang

Joyce M. Whang, Ph.D. Acting Director, Division of Reproductive, Abdominal, and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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INDICATIONS FOR USE

K071754 510(k) Number:

Device Name: KSEA Neo-vagina Surgery Set and Accessories

  • Indications for Use: The KSEA Neo-vagina Surgery Set and Accessories is indicated for use by qualified surgeons in women with congenital absence of the vagina who have failed first-line non-surgical treatment with conventional vaginal dilators. The set is used in conjunction with a laparoscopic surgical procedure to create and enlarge the vaginal cavity via continuous traction between the abdomen and vulva, and to maintain the vaginal canal after surgery.
    Prescription Use:
    (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 IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Halus Remen

(Division Sign-Off) Division of Reproductive, Abdominal, and Radiological Devices 510(k) Number

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