K Number
K080093
Device Name
PKS PLASMA MORCELLATOR, MODELS 962000PK, 3620PK
Manufacturer
Date Cleared
2008-05-02

(109 days)

Product Code
Regulation Number
878.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Gyrus ACMI PKS Plasma Morcellator is intended for cutting, coring, and extracting tissue in various operative laparoscopy procedures, including laparoscopic general surgical procedures, laparoscopic urological procedures, and laparoscopic gynecologic procedures.
Device Description
The Gyrus ACMI PKS Plasma Morcellator consists of two main elements: a Morcellator that includes a cutting shaft and handle with an integrated electrical cable that connects to a Gyrus Medical generator; and a Grasper that passes through the hollow shaft of the Morcellator, to grasp tissue and retract it toward the cutting element on the Morcellator shaft tip. An obturator may also be used to assist in the introduction of the device in laparoscopic procedures, and like the grasper, is positioned through the shaft of the Morcellator tube when being utilized
More Information

No
The description focuses on mechanical and electrical components for tissue cutting and extraction, with no mention of AI or ML terms or functionalities.

No
The device is described as being used for "cutting, coring, and extracting tissue," which are surgical procedures rather than therapeutic interventions aimed at curing, treating, or preventing disease through non-invasive means or by restoring function.

No

Explanation: The device is described as a surgical tool used for cutting, coring, and extracting tissue. Its function is to perform a physical action on tissue, not to provide diagnostic information about a medical condition.

No

The device description clearly outlines physical components including a cutting shaft, handle, electrical cable, and grasper, indicating it is a hardware device.

Based on the provided information, the Gyrus ACMI PKS Plasma Morcellator is not an IVD (In Vitro Diagnostic) device.

Here's why:

  • Intended Use: The intended use clearly states that the device is for "cutting, coring, and extracting tissue in various operative laparoscopy procedures." This describes a surgical tool used in vivo (within the living body) for tissue removal during surgery.
  • Device Description: The description details a surgical instrument with a cutting shaft, handle, and grasper, designed for use during laparoscopic procedures. This aligns with a surgical device, not a device used to test samples in vitro (outside the living body).
  • Lack of IVD Characteristics: There is no mention of the device being used to analyze biological samples (like blood, urine, tissue samples) to provide diagnostic information. IVD devices are typically used in laboratories or point-of-care settings to diagnose diseases, monitor conditions, or screen for health issues.

Therefore, the Gyrus ACMI PKS Plasma Morcellator is a surgical device, not an IVD.

N/A

Intended Use / Indications for Use

The Gyrus ACMI PKS Plasma Morcellator is intended for cutting, coring, and extracting tissue in various operative laparoscopy procedures, including laparoscopic general surgical procedures, laparoscopic urological procedures, and laparoscopic gynecologic procedures.

Product codes

GEI, HET

Device Description

The Gyrus ACMI PKS Plasma Morcellator consists of two main elements: a Morcellator that includes a cutting shaft and handle with an integrated electrical cable that connects to a Gyrus Medical generator; and a Grasper that passes through the hollow shaft of the Morcellator, to grasp tissue and retract it toward the cutting element on the Morcellator shaft tip. An obturator may also be used to assist in the introduction of the device in laparoscopic procedures, and like the grasper, is positioned through the shaft of the Morcellator tube when being utilized

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)

During design verification, the performance of the PKS Plasma Morcellator was compared against the known performance characteristics of the predicate Gynecare Laparoscopic Morcellator using the bipolar tissue cutting technology of the predicate Gyrus PlasmaCision Laparoscopic Spatula. Testing demonstrated that the performance requirements were met, and that the PKS Plasma Morcellator exhibited comparable performance characteristics to both the predicate care Laparoscopic Morcellator and predicate Gyrus PlasmaCision Laparoscopic Spatula.

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

Not Found

Predicate Device(s)

K041633, K993801

Reference Device(s)

K031085, K050550

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

MAY - 2 2008

Gyrus ACMI PKS Plasma Morcellator Gyrus ACMI, Inc. 136 Turnpike Road Southborough, MA 01772

Traditional 510(k) Notification 510(k) Summary January 11, 2008

K080093

510(k) Summary of Safety and Effectiveness Gyrus ACMI, Inc. Gyrus ACMI PKS Plasma Morcellator

Page 1 of 3

General Information

Manufacturer:

Gyrus Medical Ltd. Fortran Road, St. Mellons Cardiff UNITED KINGDOM CF3 0LT

Establishment Registration Number:

510(k) Submitter:

9617070

3003790304

Terrence E. Sullivan

January 11, 2008

Gyrus ACMI, Inc. 136 Turnpike Rd. Southborough, MA 01772-2104

Vice President, Regulatory Affairs

Establishment Registration Number:

Contact Person:

Date Prepared:

Device Description

Classification Name:

Laparoscope, Gynecologic and accessories (21 CFR 884.1720), Class II, Obstetrics/Gynecology Panel; Electrosurgical cutting and coagulation device and accessories (21 CFR 878.4400), Class II General and Plastic Surgery Panel

Gyrus Medical Solid Organ Resection Device (SORD)

Gyrus ACMI PKS Plasma Morcellator

Generic/Common Name:

Electrosurgical Instruments

Predicate Devices

Project Name:

Trade Name:

Gyrus Medical Inc. PlasmaCision Laparoscopic Spatula K041633 Ethicon Inc. Gynecare Laparoscopic Morcellator K993801

1

Traditional 510{k) Notification 510(k) Summary January 11, 2008

Intended Uses

The Gyrus ACMI PKS Plasma Morcellator is intended for cutting, coring, and extracting tissue in various operative laparoscopy procedures, including laparoscopic general surgical procedures, laparoscopic urological procedures, and laparoscopic gynecologic procedures.

Product Description

The Gyrus ACMI PKS Plasma Morcellator consists of two main elements: a Morcellator that includes a cutting shaft and handle with an integrated electrical cable that connects to a Gyrus Medical generator; and a Grasper that passes through the hollow shaft of the Morcellator, to grasp tissue and retract it toward the cutting element on the Morcellator shaft tip. An obturator may also be used to assist in the introduction of the device in laparoscopic procedures, and like the grasper, is positioned through the shaft of the Morcellator tube when being utilized

Technological Characteristics and Substantial Equivalence

The Gyrus ACMI PKS Plasma Morcellator utilizes features incorporated into the following legally marketed predicate devices:

The Gyrus ACMI PKS Plasma Morcellator utilizes the same bipolar electrosurgical energy to cut tissue as that used in the predicate Gyrus Medical Inc. PlasmaCision Laparoscopic Spatula.

The Gyrus ACMI PKS Plasma Morcellator connects to the same electrosurgical generators, the currently marketed Gyrus PlasmaKinetic SuperPulse System and Gyrus General Purpose Electrosurgical System generators, as the predicate Gyrus Medical Inc. PlasmaCision Laparoscopic Spatula. These generators were cleared. under K031085 and K050550, respectively.

The Gyrus ACMI PKS Plasma Morcellator is dimensionally similar to the predicate Ethicon Gynecare Laparoscopic Morcellator, having similar Morcellator shaft diameters.

Like the predicate Ethicon Gynecare Laparoscopic Morcellator, the Gyrus ACMI PKS Plasma Morcellator utilizes a pistol grip Morcellator with a hollow shaft through which a grasper is passed to grasp tissue to be resected.

2

Gyrus ACMI PKS Plasma Morcellator Gyrus ACMI, Inc. 136 Turnpike Road Southborough, MA 01772

Traditional 510(k) Notification 510(k) Summarv January 11, 2008

Page 3 of 3

Like the predicate Ethicon Gynecare Laparoscopic Morcellator, the Gyrus ACMI PKS Plasma Morcellator is indicated for cutting, coring, and extracting tissue in various operative laparoscopy procedures, including laparoscopic general surgical procedures, laparoscopic urological procedures, and laparoscopic gynecologic procedures.

KOQ0093

The Gyrus ACMI PKS Plasma Morcellator uses patient-contacting materials that are utilized in the predicate devices, as well as other legally marketed devices manufactured by Gyrus ACMI.

During design verification, the performance of the PKS Plasma Morcellator was compared against the known performance characteristics of the predicate Gynecare Laparoscopic Morcellator using the bipolar tissue cutting technology of the predicate Gyrus PlasmaCision Laparoscopic Spatula. Testing demonstrated that the performance requirements were met, and that the PKS Plasma Morcellator exhibited comparable performance characteristics to both the predicate care Laparoscopic Morcellator and predicate Gyrus PlasmaCision Laparoscopic Spatula.

In summary, the Gyrus ACMI PKS Plasma Morcellator is substantially equivalent to the predicate devices and presents no new questions of safety or efficacy.

3

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 stylized eagle with three stripes forming its wing and tail feathers. The eagle is positioned to the right of the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA", which is arranged in a circular fashion around the left side of the eagle.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

MAY - 2 2008

Gyrus ACMI, Inc. % Mr. Terrence E. Sullivan VP, Regulatory Affairs 136 Turnpike Road Southborough, Massachusetts 01772

Re: K080093

Trade/Device Name: Gyrus ACMI PKS Plasma Morcellator Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical cutting and coagulation device and accessories Regulatory Class: II Product Code: GEI, HET Dated: April 17, 2008 Received: April 18, 2008

Dear Mr. Sullivan:

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 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 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.

4

Page 2 - Mr. Terrence E. Sullivan

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 Center for Devices and Radiological Health's (CDRH's) Office of Compliance at (240) 276-0115. 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 Biometric's (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 yours.

Mark M. Milliman

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

Enclosure

5

Gyrus ACMI PKS Plasma Morcellator Gyrus ACMI, Inc. 136 Turnpike Road Southborough, MA 01772

Traditional 510(k) Notification Statement of Intended Use January 11, 2008

Device Name: Gyrus ACMI PKS Plasma Morcellator

510(k) Number: K080093

Statement of Intended use:

The Gyrus ACMI PKS Plasma Morcellator is intended for cutting, coring, and extracting tissue in various operative laparoscopy procedures, including laparoscopic general surgical procedures, laparoscopic urological procedures, and laparoscopic gynecologic procedures.

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

Concurrence of CDRH, Office of Device Evaluation (ODE)

Prescription Use: X

OR Over-the-Counter Use:

(Per 21 CFR 801.109)

Mark A. Mellman

Ayiston 2 . Restorative, ivision of Gener ad Neurological Devices

100 Number

K080093