K Number
K152848
Device Name
AUTOLAP SYSTEM
Date Cleared
2015-11-17

(49 days)

Product Code
Regulation Number
876.1500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The AutoLap System is indicated for General laparoscopic, Gynecologic and Urologic procedures for the purpose of holding and controlling the movement of a standard laparoscope or rigid endoscope within surgical cavities during minimally invasive laparoscopic surgery.
Device Description
The AutoLap System is designed to hold and control and the movement of a laparoscope or rigid endoscope during laparoscopic procedures. The AutoLap System includes both software and hardware. Hardware components include a Processing Unit, which includes the system's electronics and software algorithms, a Base Unit and a Laparoscopic Unit that include motors and sensors. The Base Unit is mounted on the operating bed. An accessory cart that is used for placing the system's components during the procedure and their storage afterwards is also provided. To maneuver the laparoscope to the desired position, the surgeon presses a single button, referred to as Command Unit, which is affixed to his/her hand or to the surgical instrument and transmits RF signals to the system. The movement of the laparoscope may be controlled as a simple joystick, enabling movements to up/down, left/right, zoom out directions or be guided by the movement of a designated tool within the field of view, enabling movement in oblique trajectories. Additionally, the system enables the surgeon to manually perform larger movements of the laparoscope using the Manual Activation Button affixed to the AutoLap system.
More Information

Not Found

Unknown
The document mentions "software algorithms" and "image processing" to guide movement based on a designated tool, which could potentially involve AI/ML. However, it does not explicitly state the use of AI, ML, or related terms like neural networks, nor does it provide details about training or test data sets, which are common indicators of AI/ML development. Without further information, it's impossible to definitively confirm or deny the presence of AI/ML.

No
The device is described as a system to hold and control the movement of a laparoscope or rigid endoscope during minimally invasive surgery. It facilitates the surgeon's view but does not directly treat or diagnose a disease or condition.

No

The device is designed to hold and control the movement of a laparoscope or rigid endoscope during surgery. Its function is to assist the surgeon in maneuvering the camera, not to diagnose medical conditions or interpret diagnostic images.

No

The device description explicitly states that the AutoLap System includes both software and hardware components, listing specific hardware like a Processing Unit, Base Unit, Laparoscopic Unit, and accessory cart.

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

Here's why:

  • IVD Definition: In Vitro Diagnostics are tests performed on samples taken from the human body, such as blood, urine, or tissue, to detect diseases, conditions, or infections. They are used to provide information for diagnosis, monitoring, or screening.
  • AutoLap System Function: The AutoLap System is a robotic system designed to hold and control a laparoscope or endoscope during surgical procedures within the body. It assists the surgeon with camera positioning and movement.
  • Lack of Sample Analysis: The AutoLap System does not analyze any biological samples taken from the patient. Its function is entirely focused on manipulating a surgical instrument (the laparoscope/endoscope) within the surgical cavity.

The system's purpose is to facilitate the surgical procedure itself, not to diagnose or provide information based on the analysis of biological samples.

N/A

Intended Use / Indications for Use

The AutoLap System is indicated for General laparoscopic, Gynecologic and Urologic procedures for the purpose of holding and controlling the movement of a standard laparoscope or rigid endoscope within surgical cavities during minimally invasive laparoscopic surgery.

Product codes

GCJ

Device Description

The AutoLap System is designed to hold and control and the movement of a laparoscope or rigid endoscope during laparoscopic procedures. The AutoLap System includes both software and hardware. Hardware components include a Processing Unit, which includes the system's electronics and software algorithms, a Base Unit and a Laparoscopic Unit that include motors and sensors. The Base Unit is mounted on the operating bed. An accessory cart that is used for placing the system's components during the procedure and their storage afterwards is also provided. To maneuver the laparoscope to the desired position, the surgeon presses a single button, referred to as Command Unit, which is affixed to his/her hand or to the surgical instrument and transmits RF signals to the system. The movement of the laparoscope may be controlled as a simple joystick, enabling movements to up/down, left/right, zoom out directions or be guided by the movement of a designated tool within the field of view, enabling movement in oblique trajectories. Additionally, the system enables the surgeon to manually perform larger movements of the laparoscope using the Manual Activation Button affixed to the AutoLap system.

Mentions image processing

o Image processing, system functionality, and performance to move the camera to the requested position using different modes of operation"

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

surgical cavities

Indicated Patient Age Range

Not Found

Intended User / Care Setting

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

  • Electrical safety was tested in accordance with ANSI/AAMI 60601-1:2005 - Medical electrical equipment - Part 1: General requirements for basic safety and essential performance.
  • Electromagnetic Compatibility (EMC) was tested in accordance with IEC 60601-1-2:2007 -Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic compatibility - Requirements and tests.
  • Bench testing was conducted in order to demonstrate that the AutoLap system performs according to its requirements and specifications. Testing evaluated the following:
    • Image stability
    • Image processing, system functionality, and performance to move the camera to the requested position using different modes of operation"
    • Connection, receipt and display of video Connection and display on separate monitor
  • Animal testing demonstrated the performance of the added mode of movement control.

All performance testing demonstrates that the modified AutoLap System performs according to specifications and functions as intended.

Key Metrics

Not Found

Predicate Device(s)

K131375

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.1500 Endoscope and accessories.

(a)
Identification. An endoscope and accessories is a device used to provide access, illumination, and allow observation or manipulation of body cavities, hollow organs, and canals. The device consists of various rigid or flexible instruments that are inserted into body spaces and may include an optical system for conveying an image to the user's eye and their accessories may assist in gaining access or increase the versatility and augment the capabilities of the devices. Examples of devices that are within this generic type of device include cleaning accessories for endoscopes, photographic accessories for endoscopes, nonpowered anoscopes, binolcular attachments for endoscopes, pocket battery boxes, flexible or rigid choledochoscopes, colonoscopes, diagnostic cystoscopes, cystourethroscopes, enteroscopes, esophagogastroduodenoscopes, rigid esophagoscopes, fiberoptic illuminators for endoscopes, incandescent endoscope lamps, biliary pancreatoscopes, proctoscopes, resectoscopes, nephroscopes, sigmoidoscopes, ureteroscopes, urethroscopes, endomagnetic retrievers, cytology brushes for endoscopes, and lubricating jelly for transurethral surgical instruments. This section does not apply to endoscopes that have specialized uses in other medical specialty areas and that are covered by classification regulations in other parts of the device classification regulations.(b)
Classification —(1)Class II (special controls). The device, when it is an endoscope disinfectant basin, which consists solely of a container that holds disinfectant and endoscopes and accessories; an endoscopic magnetic retriever intended for single use; sterile scissors for cystoscope intended for single use; a disposable, non-powered endoscopic grasping/cutting instrument intended for single use; a diagnostic incandescent light source; a fiberoptic photographic light source; a routine fiberoptic light source; an endoscopic sponge carrier; a xenon arc endoscope light source; an endoscope transformer; an LED light source; or a gastroenterology-urology endoscopic guidewire, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I for the photographic accessories for endoscope, miscellaneous bulb adapter for endoscope, binocular attachment for endoscope, eyepiece attachment for prescription lens, teaching attachment, inflation bulb, measuring device for panendoscope, photographic equipment for physiologic function monitor, special lens instrument for endoscope, smoke removal tube, rechargeable battery box, pocket battery box, bite block for endoscope, and cleaning brush for endoscope. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807of this chapter, subject to the limitations in § 876.9.

0

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DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

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

M.S.T. Medical Surgery Technologies Ltd % John Smith, M.D., J.D. Regulatory Counsel Hogan Lovells Us LLP 555 Thirteenth Street NW Washington, District of Columbia 20004

November 17, 2015

Re: K152848

Trade/Device Name: Autolap System Regulation Number: 21 CFR 876.1500 Regulation Name: Endoscope And Accessories Regulatory Class: Class II Product Code: GCJ Dated: September 29, 2015 Received: September 29, 2015

Dear Dr. Smith:

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

1

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.

Joshua C. Nipper -S

Binita S. Ashar, M.D., M.B.A., F.A.C.S. For Director Division of Surgical Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

Indications for Use

Form Approved: OMB No. 0910-0120 Expiration Date: January 31, 2017 See PRA Statement on last page

510(k) Number (if known)

K152848

Device Name

AutoLap

Indications for Use (Describe)

The AutoLap System is indicated for General laparoscopic, Gynecologic and Urologic procedures for the purpose of holding and controlling the movement of a standard laparoscope or rigid endoscope within surgical cavities during minimally invasive laparoscopic surgery.

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)

PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON A SEPARATE PAGE IF NEEDED.

FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

This section applies only to requirements of the Paperwork Reduction Act of 1995.

*DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW *

The burden time for this collection of information is estimated to average 79 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to:

Department of Health and Human Services Food and Drug Administration Office of Chief Information Officer Paperwork Reduction Act (PRA) Staff PRAStaff@fda.hhs.gov

"An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number."

FORM FDA 3881 (1/14)

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510(k) SUMMARY

MST's AutoLap

Submitter's Name, Address, Telephone Number, Contact Person and Date Prepared

M.S.T Medical Surgery Technologies Ltd. Kochav Yokneam Building. Floor 5. Yokneam Ilit 2069200, Israel Phone: +972-73-796-5570 Facsimile: +972-73-796-5571 Contact Person: Tami Harel

Date Prepared: November 12, 2015

Name of Device and Name/Address of Sponsor

AutoLap System M.S.T Medical Surgery Technologies Ltd. Kochav Yokneam Building, Floor 5, Yokneam Ilit 2069200, Israel

Common or Usual Name Laparoscope Holder

Classification Name Laparoscope, General and Plastic Surgery

Predicate Devices AutoLap manufactured by M.S.T. Medical Surgery Technologies (K131375)

Purpose of the 510(k) notice

The AutoLap is a modification to the cleared AutoLap device.

Indications for Use Statement

The AutoLap System is indicated for General laparoscopic, Gynecologic and Urologic procedures for the purpose of holding and controlling the movement of a standard laparoscope or rigid endoscope within surgical cavities during minimally invasive laparoscopic surgery.

Technological Characteristics

The AutoLap System is designed to hold and control and the movement of a laparoscope or rigid endoscope during laparoscopic procedures. The AutoLap System includes both software and hardware. Hardware components include a Processing Unit, which includes the system's electronics and software algorithms, a Base Unit and a Laparoscopic Unit that include motors and sensors. The

4

Base Unit is mounted on the operating bed. An accessory cart that is used for placing the system's components during the procedure and their storage afterwards is also provided.

To maneuver the laparoscope to the desired position, the surgeon presses a single button, referred to as Command Unit, which is affixed to his/her hand or to the surgical instrument and transmits RF signals to the system. The movement of the laparoscope may be controlled as a simple joystick, enabling movements to up/down, left/right, zoom out directions or be guided by the movement of a designated tool within the field of view, enabling movement in oblique trajectories. Additionally, the system enables the surgeon to manually perform larger movements of the laparoscope using the Manual Activation Button affixed to the AutoLap system.

Performance Data

The following testing was repeated to evaluate the modified device:

  • . Electrical safety was tested in accordance with ANSI/AAMI 60601-1:2005 - Medical electrical equipment - Part 1: General requirements for basic safety and essential performance.
  • . Electromagnetic Compatibility (EMC) was tested in accordance with IEC 60601-1-2:2007 -Medical electrical equipment - Part 1-2: General requirements for basic safety and essential performance - Collateral standard: Electromagnetic compatibility - Requirements and tests.
  • . Bench testing was conducted in order to demonstrate that the AutoLap system performs according to its requirements and specifications. Testing evaluated the following:
    • o Image stability
    • O lmage processing, system functionality, and performance to move the camera to the requested position using different modes of operation"
    • Connection, receipt and display of video Connection and display on separate monitor o
  • . Animal testing demonstrated the performance of the added mode of movement control.

All performance testing demonstrates that the modified AutoLap System performs according to specifications and functions as intended.

Substantial Equivalence

The modified AutoLap system has the same intended use and indications, similar principles of operation, and technological characteristics as the cleared AutoLap system. The modified AutoLap includes an additional mode of operation that can be selected by the surgeon which allows for laparoscope camera movement to be controlled by the movement of a designated tool within the field of view. Additionally, the modified AutoLap includes means for the connection of a separate monitor to allow for a parallel display. The minor differences in the modified AutoLap technological characteristics do not raise any new or different questions of safety or effectiveness. Performance data demonstrates that the modified AutoLap system is as safe and effective as the cleared AutoLap device. Thus, the modified AutoLap system is substantially equivalent to its predicate devices.