K Number
K124029
Device Name
MICROLINE FLEXIBLE LIGATING SHEARS
Date Cleared
2013-03-27

(89 days)

Product Code
Regulation Number
878.4400
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Microline Flexible Ligating Shears are intended for simultaneous cutting and cauterization of soft tissue during minimally invasive abdominal laparoscopic surgery. The device may also be used for cutting natural, non-metallic sutures during surgery.
Device Description
The Microline Flexible Ligating Shears system consists of the following: Microline Flexible Ligating Shears Microline Universal Power Supply Single or multiple access port device such as the TransEnterix SPIDER Single Port. The Microline Flexible Ligating Shears are designed to provide thermal ligation and division during minimally invasive abdominal laparoscopic surgery. The Microline Flexible Ligating Shears consist of a sterile single patient use handpiece. The device has heating elements at the distal tip which are activated by a finger switch located on the handpiece of the device. The Microline Universal Power Supply is designed to allow the surgeon control of the heating element power of the device in order to accommodate for individual patient anatomy. An instrument cord is attached to the handpiece and is plugged into the dedicated Microline Universal Power Supply. The Microline Flexible Ligating Shears are designed to be used with an Introducer such as the SPIDER Single Port Device. The Microline Flexible Ligating Shears are supplied sterile in a Tyvek/Mylar sterilization pouch on a mounting card and thermoformed tray, placed in a fiberboard carton. The device is intended to be used by a trained physician for a single patient use during minimally invasive abdominal laparoscopic surgery. The Microline Flexible Ligating Shears power cable is attached to the instrument handpiece and connects to the Microline Universal Power Supply. The Universal Power Supply is supplied nonsterile for reusable use outside the sterile field. The Microline Flexible Ligating Shears incorporates Hi and Low heating modes that are used to cauterize and cut soft tissue. The heating elements in the tip are activated by a physician controlled finger switch located on the handpiece of the device. The Microline Flexible Ligating Shears is intended to provide general purpose cauterization, spreading, and grasping of soft tissue during minimally invasive or open surgical procedures.
More Information

Not Found

No
The device description focuses on mechanical and electrical components for cutting and cauterization, with no mention of AI or ML algorithms for decision-making, image analysis, or adaptive control. The power supply offers user-controlled heating modes, not automated or learned adjustments.

No.
The device is used for cutting and cauterizing soft tissue during surgery, which are surgical procedures, not therapeutic treatments.

No

The device is described as surgical shears intended for cutting and cauterization of soft tissue, primarily during minimally invasive abdominal laparoscopic surgery. Its functions are therapeutic (cutting, cauterizing, ligating), not diagnostic.

No

The device description clearly outlines multiple hardware components including the handpiece, heating elements, finger switch, instrument cord, and a universal power supply. It is a physical surgical instrument system, not a software-only device.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • IVD Definition: In Vitro Diagnostic devices are used to examine specimens taken from the human body (like blood, urine, tissue) to provide information about a person's health, diagnose conditions, or monitor treatments. This testing is done outside the body (in vitro).
  • Device Function: The Microline Flexible Ligating Shears are used directly on soft tissue within the body during surgery for cutting and cauterization. This is an in vivo (within the living body) procedure.

The description clearly states the device's purpose is for surgical procedures on soft tissue, not for analyzing samples taken from the body.

N/A

Intended Use / Indications for Use

The Microline Flexible Ligating Shears are intended for simultaneous cutting and cauterization of soft tissue during minimally invasive abdominal laparoscopic surgery. The device may also be used for cutting natural, non-metallic sutures during surgery.

Product codes

GEI

Device Description

The Microline Flexible Ligating Shears system consists of the following:

Microline Flexible Ligating Shears
Microline Universal Power Supply
Single or multiple access port device such as the TransEnterix SPIDER Single Port.

The Microline Flexible Ligating Shears are designed to provide thermal ligation and division during minimally invasive abdominal laparoscopic surgery. The Microline Flexible Ligating Shears consist of a sterile single patient use handpiece. The device has heating elements at the distal tip which are activated by a finger switch located on the handpiece of the device. The Microline Universal Power Supply is designed to allow the surgeon control of the heating element power of the device in order to accommodate for individual patient anatomy. An instrument cord is attached to the handpiece and is plugged into the dedicated Microline Universal Power Supply.

The Microline Flexible Ligating Shears are designed to be used with an Introducer such as the SPIDER Single Port Device.

The Microline Flexible Ligating Shears are supplied sterile in a Tyvek/Mylar sterilization pouch on a mounting card and thermoformed tray, placed in a fiberboard carton. The device is intended to be used by a trained physician for a single patient use during minimally invasive abdominal laparoscopic surgery.

The Microline Flexible Ligating Shears power cable is attached to the instrument handpiece and connects to the Microline Universal Power Supply. The Universal Power Supply is supplied nonsterile for reusable use outside the sterile field.

The Microline Flexible Ligating Shears incorporates Hi and Low heating modes that are used to cauterize and cut soft tissue. The heating elements in the tip are activated by a physician controlled finger switch located on the handpiece of the device. The Microline Flexible Ligating Shears is intended to provide general purpose cauterization, spreading, and grasping of soft tissue during minimally invasive or open surgical procedures.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Abdominal

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Trained physician / minimally invasive abdominal laparoscopic surgery

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)

The Microline Flexible Ligating Shears have been tested for functionality and they have found to perform their intended functions for minimally invasive abdominal laparoscopic procedures. Additionally, testing has proven that they perform their ligating functions. The device has also been tested with the SPIDER® device and pasted all required testing for system compatibility.

The Microline Thermal Ligating Shears have been sterilized to a SAL of 1x10* using gamma irradiation. The gamma sterilization process was validated to the following: - Clause 9, Method VDmax -Substantiation of 25 kGy or 15 kGy as the sterilization dose in ISO 11137-2. Sterile barrier testing has been performed and it has been shown that the sterile barrier has the capability of maintaining sterility during the required shelf life, and that the device itself maintains its performance requirements.

Biocompatibility testing was successfully conducted on the Microline Flexible Ligating Shears in accordance with ANSI/AAMI/ISO 10993-1. The Microline Flexible Ligating Shears falls into the category of external communicating device and the appropriate tests were performed as described in Table A.1 in Annex A of ANSI/AAMI/ISO 10993-1.

The Microline Flexible Ligating Shears were evaluated by an independent testing laboratory and found compliant to IEC 60601-1:1988 + A1:1999 + A2:1995 general requirements for basic safety, including all US, CAN National Differences.

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

Not Found

Predicate Device(s)

K062257, K122299

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

K124029

800 Cummings Center, Suite 166T Beverly, MA 01915, USA Tel: 978.922.9810 Fax: 978.922.9209 Web: www.microlinesurgical.com

510(k) Summary

MAR 2 7 2013

Submitted By:Microline Surgical
Contact Person:Bill McCallum
Date Prepared:February 19, 2013
Proprietary Name:Microline Flexible Ligating Shears
Classification Name:Electrosurgical Cutting and Coagulation and Accessories
21 CFR § 878.4400
79 GEI
Predicate Devices:This product is similar in design, composition, to and function to the:
Thermal Ligating Shears (K062257) cleared on October 10, 2006 and the
Spider Flexible Monopolar Surgical Instruments (K122299) cleared on
October 25, 2012.

Device Description and Technological Characteristics:

The Microline Flexible Ligating Shears system consists of the following:

Microline Flexible Ligating Shears Microline Universal Power Supply Single or multiple access port device such as the TransEnterix SPIDER Single Port.

The Microline Flexible Ligating Shears are designed to provide thermal ligation and division during minimally invasive abdominal laparoscopic surgery. The Microline Flexible Ligating Shears consist of a sterile single patient use handpiece. The device has heating elements at the distal tip which are activated by a finger switch located on the handpiece of the device. The Microline Universal Power Supply is designed to allow the surgeon control of the heating element power of the device in order to accommodate for individual patient anatomy. An instrument cord is attached to the handpiece and is plugged into the dedicated Microline Universal Power Supply.

The Microline Flexible Ligating Shears are designed to be used with an Introducer such as the SPIDER Single Port Device.

Image /page/0/Picture/11 description: The image shows a circular design. The design is composed of four curved shapes that resemble petals or lenses, arranged symmetrically around a central point. The shapes are enclosed within a circle, creating a pattern that looks like a stylized flower or a geometric emblem.

Image /page/0/Picture/12 description: The image contains two logos. The logo on the left is a circle with a checkmark inside, and the text "TÜV SÜD, SRQ" is written around the circle. The logo on the right has a crown on top of a checkmark, and the text "UKAS Product Certification 026" is written below the checkmark. Both logos appear to be certification marks.

1

The Microline Flexible Ligating Shears are supplied sterile in a Tyvek/Mylar sterilization pouch on a mounting card and thermoformed tray, placed in a fiberboard carton. The device is intended to be used by a trained physician for a single patient use during minimally invasive abdominal laparoscopic surgery.

The Microline Flexible Ligating Shears power cable is attached to the instrument handpiece and connects to the Microline Universal Power Supply. The Universal Power Supply is supplied nonsterile for reusable use outside the sterile field.

The Microline Flexible Ligating Shears incorporates Hi and Low heating modes that are used to cauterize and cut soft tissue. The heating elements in the tip are activated by a physician controlled finger switch located on the handpiece of the device. The Microline Flexible Ligating Shears is intended to provide general purpose cauterization, spreading, and grasping of soft tissue during minimally invasive or open surgical procedures.

Principle of Operation:

The Microline Flexible Ligating Shears provide a path of entry to the surgical target by the SPIDER device's flexible extended IDTs (Instrument Delivery Tube), also called the SPIDER Single Port Device. Two (2) flexible channels known as IDTs (Instrument Delivery Tubes) are positioned horizontally to the operative plane and include extended flexible lumens to facilitate manipulation of surgical instruments, enabling control over operator determined distances. The IDTs facilitate x, y, and z motion to allow for a multidirectional and triangulated approach within the surgical field. This mimics the approach of standard laparoscopic surgery using multiple incisions.

The flexible IDTs provide 360 degrees of freedom at the distal tips. The right hand controls the right instrument and the left hand controls the left instrument. Two (2) rigid channels positioned vertically to the operative field enable the use of an endoscope and any other surgical instruments.

Indications for Use:

The Microline Flexible Ligating Shears are intended for simultaneous cutting and cauterization of soft tissue during minimally invasive abdominal laparoscopic surgery. The device may also be used for cutting natural, non-metallic sutures during surgery.

Performance Testing:

The Microline Flexible Ligating Shears have been tested for functionality and they have found to perform their intended functions for minimally invasive abdominal laparoscopic procedures. Additionally, testing has proven that they perform their ligating functions. The device has also been tested with the SPIDER® device and pasted all required testing for system compatibility.

The Microline Thermal Ligating Shears have been sterilized to a SAL of 1x10* using gamma irradiation. The gamma sterilization process was validated to the following: - Clause 9, Method VDmax -Substantiation of 25 kGy or 15 kGy as the sterilization dose in ISO 11137-2. Sterile barrier testing has

Image /page/1/Picture/12 description: The image shows a circular design. The design is composed of four leaf-like shapes arranged symmetrically around a central point. The leaves are oriented so that their pointed ends face outward, creating a pattern that resembles a four-petal flower or a stylized compass rose.

2

been performed and it has been shown that the sterile barrier has the capability of maintaining sterility during the required shelf life, and that the device itself maintains its performance requirements.

Biocompatibility testing was successfully conducted on the Microline Flexible Ligating Shears in accordance with ANSI/AAMI/ISO 10993-1. The Microline Flexible Ligating Shears falls into the category of external communicating device and the appropriate tests were performed as described in Table A.1 in Annex A of ANSI/AAMI/ISO 10993-1.

The Microline Flexible Ligating Shears were evaluated by an independent testing laboratory and found compliant to IEC 60601-1:1988 + A1:1999 + A2:1995 general requirements for basic safety, including all US, CAN National Differences.

As illustrated in the Predicate Comparison Table below, the Microline Flexible Ligating Shears do not incorporate any significant technological differences that effect safety and efficacy. Therefore clinical data was not necessary for evaluation of substantial equivalence. The verification and validation test results are sufficient to demonstrate safety and effectiveness when compared to the predicate devices. The minor design or material differences between The Microline Thermal Ligating Shears and the predicate devices have been evaluated and tested and found to present no new issues of safety and effectiveness.

| Characteristic | Starion Instruments
Corporation TLS3
Thermal Ligating Shears
510(k) K062257 (Predicate
device) | Microline Flexible Ligating
Shears (subject of this
submission) | Transenterix Spider Flexible
Monopolar Surgical
Instruments K122299
(Predicate device) |
|---------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Indications for
Use | For the simultaneous
cutting and cauterization of
soft tissue during surgery,
and cutting of natural or
synthetic, non-metallic
sutures during surgery. | The Microline Flexible
Ligating Shears are intended
for simultaneous cutting and
cauterization of soft tissue
during minimally invasive
abdominal laparoscopic
surgery. The device may also
be used for cutting natural,
non-metallic sutures during
surgery. | The Spider Surgical Instruments
are intended for use on
minimally invasive abdominal
laparoscopic surgical procedures
for grasping, mobilizing,
dissecting, retracting, cutting,
cauterizing, ligating,
suction/irrigation and other
manipulation of tissues and
vessels during laparoscopic
surgery. |
| Principle of
Operation | Heat is conducted to tissue
compressed within the jaws
via heating elements in the
instrument tip. | Same | Monopolar high frequency
current passes from active jaw
tips of instrument to cut a
coagulate tissue at the immediate
surgical site, flowing through the
patient to an adhesive electrode
return pad connected to the
monopolar electrosurgical
generator. |
| Energy Source | Electrical current from
Starion Instruments
Universal Power Supply
(UPS) | Same | Electrical high frequency current
and voltage from a third party
monopolar electrosurgical unit
(ESU). |

Predicate Comparison Table:

Image /page/2/Picture/6 description: The image contains the text "Confidence, simply delivered." The text is written in a bold, sans-serif font. The text is black and is set against a white background. The text appears to be a slogan or tagline for a company or product.

Image /page/2/Picture/7 description: The image shows a circular design composed of four leaf-like shapes arranged symmetrically around a central point. Each leaf shape has a curved outline and tapers to a point at both ends. The overall impression is that of a stylized flower or a geometric pattern with organic elements. The image is in black and white.

Image /page/2/Picture/8 description: The image contains two logos. The logo on the left is a circle with a checkmark inside, and the letters "SGS" are written below. The logo on the right is a checkmark with Arabic text below. Both logos appear to be certification marks.

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| Method of

ActuationFinger switchSameSame
SterilityGamma radiation, sterility
assurance level (SAL) is $10^6$SameSame
Cleaning and re-
sterilization of
the reusable
hand pieceN/A
Sterile for single use only.SameSame
Primary Sterile
BarrierTyvek/Mylar pouchSameSame
BiocompatibilityAll patient contact
materials meet
biocompatibility test per
ISO 10993-1SameSame
Energy Used
and/or
DeliveredMaximum Output - 60WSameMonopolar high frequency
output.
Rigidity/Flexibil
ityRigid, not flexibleFunctions with the
TransEnterix SPIDER Single
Port DeviceFunctions with the TransEnterix
SPIDER Single Port Device

Summary:

The information provided demonstrates that the Microline Flexible Ligating Shears is substantially equivalent to the Thermal Ligating Shears (K062257) and the Spider Flexible Monopolar Surgical Instruments (K122299) cleared on October 25, 2012, in function, intended use and indications for use.

Image /page/3/Picture/5 description: The image contains two certification logos. The logo on the left is the SGS certification mark, which features a stylized checkmark within a circular design. The logo on the right is the UKAS (United Kingdom Accreditation Service) certification mark, which includes a crown above a checkmark and the text "UKAS Accredited Management Systems 005".

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Image /page/4/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo is circular, with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" arranged around the perimeter of the circle. Inside the circle is a stylized image of an eagle.

Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

Microline, Surgical, Incorporated % Mr. Bill McCallum Regulatory Affairs Manager 800 Cummings Center, Suite 166T Beverly, Massachusetts 01915

March 27, 2013

Re: K124029 Trade/Device Name: Microline Flexible Ligating Shears Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical cutting and coagulation device and accessories Regulatory Class: Class II Product Code: GEI Dated: December 26, 2012 Received: December 28, 2012

Dear Mr. McCallum:

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 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); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); 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.

5

Page 2 - Mr. Bill McCallum

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/cdrh/mdr/ for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

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 (301) 796-7100 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours, FOR

Peter D. Rumm -S

Mark N. Melkerson Acting Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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510(k) Number (if known): K124029

Indications for Use

Device Name: Microline Flexible Ligating Shears

Indications for Use:

The Microline Flexible Ligating Shears are intended for simultaneous cutting and cauterization of soft tissue during minimally invasive abdominal laparoscopic surgery. The device may also be used for cutting natural, non-metallic sutures during surgery.

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)

Joshua C. Nipper -S

For

(Division Sign-Off) Division of Surgical Devices 510(k) Number __K124029

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