K Number
K143308
Device Name
GelPOINT Transvaginal Access Platform
Date Cleared
2015-10-13

(329 days)

Product Code
Regulation Number
884.1640
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The GelPOINT Transvaginal Access Platform is intended to be inserted transvaginally to establish a path of entry for minimally invasive instruments while maintaining pneumoperitoneum during laparoscopic hysterectomy. The instrument is indicated for use in laparoscopic assisted vaginal hysterectomies. The instrument is also a conduit for the extraction of specimens.
Device Description
The GelPOINT Transvaginal Access Platform is a sterile, single use instrument that allows access to the vagina to perform laparoscopic assisted hysterectomy. The device consists of a cannula with suture ties, and a cap made of a flexible gel-like material. The gel cap has two stopcocks that can be used for insufflation or smoke evacuation. Four trocars are included and may be placed through the gel cap. The trocars allow insertion of standard laparoscopic instruments into the vagina. Construction materials include various polymers, silicone and stainless steel. Packaging consists of a PTEG tray that is placed in a Tyvek/Mylar pouch and shipped in a carton. Sterilization is via Gamma irradiation; sterility assurance level is 10°.
More Information

No
The summary describes a mechanical surgical access platform and does not mention any software, algorithms, or data processing that would indicate the use of AI/ML.

No.
This device is an access platform and conduit for instruments and specimen extraction during surgery, not a device that treats or prevents a disease or condition.

No
The device is described as an access platform for surgical instruments used in laparoscopic hysterectomy and specimen extraction, not for diagnosing medical conditions.

No

The device description clearly outlines physical components such as a cannula, cap, stopcocks, and trocars, made of polymers, silicone, and stainless steel. It also mentions sterilization and packaging, indicating a physical medical device, not software only.

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

Here's why:

  • Intended Use: The intended use clearly describes a device used during a surgical procedure (laparoscopic hysterectomy) to provide access and maintain pneumoperitoneum. It is a surgical access platform.
  • Device Description: The description details a physical instrument with a cannula, cap, stopcocks, and trocars for inserting surgical instruments.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens in vitro (outside the body) to provide information about a patient's health status, diagnose, monitor, or screen for diseases.

IVD devices are typically used to test samples like blood, urine, tissue, etc., to provide diagnostic information. This device is a surgical tool used on the patient during a procedure.

N/A

Intended Use / Indications for Use

The GelPOINT Transvaginal Access Platform is intended to be inserted transvaginally to establish a path of entry for minimally invasive instruments while maintaining pneumoperitoneum during laparoscopic hysterectomy. The instrument is indicated for use in laparoscopic assisted vaginal hysterectomies. The instrument is also a conduit for the extraction of specimens.

Product codes

HEW

Device Description

The GelPOINT Transvaginal Access Platform is a sterile, single use instrument that allows access to the vagina to perform laparoscopic assisted hysterectomy. The device consists of a cannula with suture ties, and a cap made of a flexible gel-like material. The gel cap has two stopcocks that can be used for insufflation or smoke evacuation. Four trocars are included and may be placed through the gel cap. The trocars allow insertion of standard laparoscopic instruments into the vagina. Construction materials include various polymers, silicone and stainless steel.

Packaging consists of a PTEG tray that is placed in a Tyvek/Mylar pouch and shipped in a carton. Sterilization is via Gamma irradiation; sterility assurance level is 10°.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

vagina

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

Biocompatibility testing: The subject device is an External Communicating Device that contacts Tissue/Bone/Dentin for less than 24 hours. The portion of the device that contacts tissue is the cannula, dilator and the cap ring. Biocompatibility testing on the reference device (K133393), which is identical in materials and composition to the subject device, were leveraged to support the biocompatibility of the subject device. All patient-contacting device components have passed biocompatibility testing required by ISO 10993-1 and FDA General Program Memorandum G95-1. These tests include:

  • Cytotoxicity
  • Sensitization
  • Irritation

Mechanical testing: There are no published performance standards for devices of this type. Therefore, Applied Medical created a dedicated test method designed to confirm substantial equivalence to the Gynetech McCartney Access Tube. These tests focused on:

  • Sealing against insufflation pressure, with and without instruments in place
  • Fixation in the vagina

Key Metrics

Not Found

Predicate Device(s)

K051594

Reference Device(s)

K133393

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 884.1640 Culdoscope and accessories.

(a)
Identification. A culdoscope is a device designed to permit direct viewing of the organs within the peritoneum by a telescopic system introduced into the pelvic cavity through the posterior vaginal fornix. It is used to perform diagnostic and surgical procedures on the female genital organs. This generic type of device may include trocar and cannula, instruments used through an operating channel, scope preheaters, light source and cables, and component parts.(b)
Classification. (1) Class II (performance standards).(2) Class I for culdoscope accessories that are not part of a specialized instrument or device delivery system; do not have adapters, connectors, channels, or do not have portals for electrosurgical, laser, or other power sources. Such culdoscope accessory instruments include: lens cleaning brush, biopsy brush, clip applier (without clips), applicator, cannula (without trocar or valves), ligature carrier/needle holder, clamp/hemostat/grasper, curette, instrument guide, ligature passing and knotting instrument, suture needle (without suture), retractor, mechanical (noninflatable), snare, stylet, forceps, dissector, mechanical (noninflatable) scissors, and suction/irrigation probe. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807 of this chapter, subject to the limitations in § 884.9.

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Image /page/0/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 circumference. Inside the circle is an abstract symbol that resembles a stylized caduceus or a series of human profiles, stacked one behind the other.

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

October 13, 2015

Applied Medical Resources Frans VandenBroek Principal Regulatory Affairs Specialist 22872 Avenida Empresa Rancho Santa Margarita, CA 92688

Re: K143308

Trade/Device Name: GelPOINT Transvaginal Access Platform, Models: C2A00, C2A01, C2A02 Regulation Number: 21 CFR 884.1640 Regulation Name: Culdoscope and accessories Regulatory Class: II Product Code: HEW Dated: September 10, 2015 Received: September 29, 2015

Dear Frans VandenBroek,

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. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

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

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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.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 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/MedicalDevices/Safety/ReportaProblem/default.htm 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 Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Benjamin R. Fisher -S

Benjamin R. Fisher, Ph.D. Director Division of Reproductive, Gastro-Renal, and Urological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration

Indications for Use

510(k) Number (if known) K143308

Device Name

GelPOINT Transvaginal Access Platform, Models: C2A00, C2A01, C2A02.

Indications for Use (Describe)

The GelPOINT Transvaginal Access Platform is intended to be inserted transvaginally to establish a path of entry for minimally invasive instruments while maintaining pneumoperitoneum during laparoscopic hysterectory. The instrument is indicated for use in laparoscopic assisted vaginal hysterectomies. The instrument is also a conduit for the extraction of specimens.

Type of Use (Select one or both, as applicable)

Prescription Use (Part 21 CFR 801 Subpart D)

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

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510(k) SUMMARY

I. SUBMITTER

Applied Medical Resources Corporation 22872 Avenida Empresa Rancho Santa Margarita, CA, 92688

Phone: (949) 713-8000 FAX: (949) 713-8205

Contact Person: Frans VandenBroek Date Prepared: Oct 12, 2015

II. DEVICE

Name: GelPOINT Transvaginal Access Platform, Models: C2A00, C2A01, C2A02 Common name: Transvaginal Access Device Classification Name: Culdoscope and Accessories, (21CFR 884.1640) Regulatory Class: II Product code: HEW.

PREDICATE DEVICE III.

McCartney Access Tube, Gynetech Pty. LTD (K051594)

Reference Device: Applied Medical GelPOINT Path Transanal Surgery Device (K133393)

IV. DEVICE DESCRIPTION

The GelPOINT Transvaginal Access Platform is a sterile, single use instrument that allows access to the vagina to perform laparoscopic assisted hysterectomy. The device consists of a cannula with suture ties, and a cap made of a flexible gel-like material. The gel cap has two stopcocks that can be used for insufflation or smoke evacuation. Four trocars are included and may be placed through the gel cap. The trocars allow insertion of standard laparoscopic instruments into the vagina. Construction materials include various polymers, silicone and stainless steel.

Packaging consists of a PTEG tray that is placed in a Tyvek/Mylar pouch and shipped in a carton. Sterilization is via Gamma irradiation; sterility assurance level is 10°.

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V. INDICATIONS FOR USE

The GelPOINT Transvaginal Access Platform is intended to be inserted transvaginally to establish a path of entry for minimally invasive instruments while maintaining pneumoperitoneum during laparoscopic hysterectomy. The instrument is indicated for use in laparoscopic assisted vaginal hysterectomies. The instrument is also a conduit for the extraction of specimens.

VI. COMPARISON OF TECHNOLOGICAL CHARACTERISTICS WITH THE PREDICATE DEVICE

GelPOINT and predicate device have different technological characteristics as follows:

  • GelPOINT is delivered in three diameters and lengths; predicate is delivered in two ● diameters.
  • GelPOINT is shorter.
  • GelPOINT has (up to) four access ports. The predicate has three.
  • GelPOINT uses an introducer to facilitate insertion. ●
  • GelPOINT uses sutures for fixation to the patient. The predicate connects to the surgical drapes using towel clips.

VII. PERFORMANCE DATA

The following performance data support determination of substantial equivalence.

Biocompatibility testing

The subject device is an External Communicating Device that contacts Tissue/Bone/Dentin for less than 24 hours. The portion of the device that contacts tissue is the cannula, dilator and the cap ring. Biocompatibility testing on the reference device (K133393), which is identical in materials and composition to the subject device, were leveraged to support the biocompatibility of the subject device. All patient-contacting device components have passed biocompatibility testing required by ISO 10993-1 and FDA General Program Memorandum G95-1. These tests include:

  • Cytotoxicity ●
  • Sensitization ●
  • Irritation ●

Mechanical testing

There are no published performance standards for devices of this type. Therefore, Applied Medical created a dedicated test method designed to confirm substantial equivalence to the Gynetech McCartney Access Tube. These tests focused on:

  • Sealing against insufflation pressure, with and without instruments in place ●
  • o Fixation in the vagina

VIII. CONCLUSIONS

The Applied Medical GelPOINT Transvaginal Access Platform is substantially equivalent to the predicate Gynetech McCartney Access Tube.