K Number
K162710
Device Name
Single Use Circular Stapler, Single Use Hemorrhodial Circular Stapler, Single Patient Use Linear Stapler and Reload, Single Patient Use Linear Cutter and Reload, Single Patient Use Endo Cutter and Reload, Single Patient Use Transverse Cutter and Reload
Date Cleared
2017-02-09

(134 days)

Product Code
Regulation Number
878.4750
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Single Use Circular Stapler has application throughout the alimentary tract for end to side and side to side anastomoses. The Single Patient Use Endo Cutter and Reload is intended for transection, and/or creation of anastomoses. The instrument has application in multiple open or minimally invasive general, gynecologic, thoracic, and pediativ surgical procedures. It can be used with tissue buttressing materials. The Single Patient Use Linear Cutter and Reload are intended for use in multiple open or minimally invasive surgical procedures for the transection of tissues. Linear cutters are also intended for creation of anastomoses in these procedures. The Single Patient Use Linear Stapler and Reload has applications in abdominal, gynecological, pediatric and thoracic surgical procedures for resection of tissue and creation of anastomosis, including occlusion of the left atrial appendage in open procedures. They may be used for transection and resection of pancreas. The Single Use Hemorrhoidal Circular Stapler has application throughout the anal to perform surgical treatment of hemorrhoidal disease. The Single Patient Use Transverse Cutter and Reload is intended for transection and or creation of anastomoses. The instrument has application in multiple open or minimally invasive general (gastrointestinal and skeletal muscle stapling), gynecologic, urologic, and thoracic surgical procedures.
Device Description
The Single Patient Use Transverse Cutter and Reload places four staggered curved row of titanium staples on the tissue upon activation, and cut the tissue between staple lines. The device is available in 40mm length with reload in 3.8mm and 4.5mm staple size. The device may be reloaded and fired up to 5 times in a single procedure. Single Use Circular stapler places a double staggered, circular row of titanium staples upon activation, which was achieved by squeezing the handles firmly as far as they could go. Immediately after formation of the staples, the excess tissue will be resect by the circular knife, and then a circular anastomosis is created. The stapler are available in 21mm, 29mm, 32mm and 34mm six specifications. The staple sizes are 4.8mm and 5.5mm. Single Patient Use Endo Cutter and Reload places two, triple-staggered rows of titanium staples and simultaneously divides the tissue from central line. The devices are available in 30mm, 45mm and 60mm three lengths. Reloads are available in six staple sizes to accommodate various tissue thicknesses: 2.0mm, 2.5mm, 3.5mm, 3.8mm, 4.1mm, 4.2mm. The device may be reloaded and fired up to 5 times in a single procedure. Single Patient Use Linear Stapler and Reload places a double staggered row of titanium staples and is available in 30mm, 45mm, 60mm, 75mm and 90mm staple for use in various applications. Three staple sizes (2.5mm, 3.8mm and 4.5mm) are available to accommodate various tissue thicknesses. It may be reloaded and fired up to 4 times for a total 5 firing in a single procedure. Single Patient Use Linear Cutter and Reload place two double staggered rows of titanium staples and simultaneously cut and divides tissue between the two double rows. The devices are available in 55mm, 60mm, 75mm, 80mm and 100mm lengths. Reloads are available in four staple sizes to accommodate various tissue thicknesses: 2.5mm, 4.2mm and 4.5mm. It may be reloaded and fired up to 4 times for a total 5 firings in a single procedure. Single Use Hemorrhoidal Circular Stapler is a set of instruments that place a double staggered, circular row of titanium staples. Immediately after the formation of staples, the circular knife blade resects the excess of compressed mucosa. The stapler are available in 30mm, 34mm and 36mm four specifications. The staple size is 4.5mm. It cannot be reloaded.
More Information

No
The device descriptions and intended uses are purely mechanical in nature, describing the physical action of stapling and cutting tissue. There is no mention of any computational analysis, decision-making, or learning capabilities. The performance studies focus on mechanical and biological compatibility standards, not algorithmic performance.

No.
The devices described are surgical staplers and cutters used for transection, resection, and creation of anastomoses, which are surgical tools that perform mechanical functions during procedures rather than providing therapy.

No

Explanation: The devices described are surgical staplers and cutters used for transection, resection, and creation of anastomoses in various surgical procedures. They are tools for performing medical interventions, not for diagnosing conditions.

No

The device description clearly details physical components like titanium staples, handles, knives, and reloadable cartridges, indicating it is a hardware device. The performance studies also focus on non-clinical tests related to physical properties and standards for medical devices with hardware components.

Based on the provided information, no, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use clearly describes surgical procedures involving the transection, creation of anastomoses, and resection of tissues within the human body. This is a direct surgical intervention, not a diagnostic test performed on samples outside the body.
  • Device Description: The device description details mechanical staplers and cutters used to physically manipulate and join tissues during surgery. This aligns with surgical tools, not diagnostic instruments.
  • Lack of Diagnostic Elements: There is no mention of analyzing biological samples (blood, urine, tissue, etc.) or providing information for the diagnosis of a disease or condition.
  • Anatomical Site: The anatomical sites listed are internal body parts where surgical procedures are performed.
  • Performance Studies: The performance studies focus on non-clinical tests verifying design specifications and substantial equivalence to predicate surgical staplers and cutters. There are no studies related to diagnostic accuracy or performance on biological samples.

In summary, the device is a surgical tool used for physically altering tissues during procedures, which is fundamentally different from an in vitro diagnostic device used to analyze samples for diagnostic purposes.

N/A

Intended Use / Indications for Use

The Single Use Circular Stapler has application throughout the alimentary tract for end to side and side to side anastomoses.

The Single Patient Use Endo Cutter and Reload is intended for transection, and/or creation of anastomoses. The instrument has application in multiple open or minimally invasive general, gynecologic, thoracic, and pediativ surgical procedures. It can be used with tissue buttressing materials.

The Single Patient Use Linear Cutter and Reload are intended for use in multiple open or minimally invasive surgical procedures for the transection of tissues. Linear cutters are also intended for creation of anastomoses in these procedures.

The Single Patient Use Linear Stapler and Reload has applications in abdominal, gynecological, pediatric and thoracic surgical procedures for resection of tissue and creation of anastomosis, including occlusion of the left atrial appendage in open procedures. They may be used for transection and resection of pancreas.

The Single Use Hemorrhoidal Circular Stapler has application throughout the anal to perform surgical treatment of hemorrhoidal disease.

The Single Patient Use Transverse Cutter and Reload is intended for transection and or creation of anastomoses. The instrument has application in multiple open or minimally invasive general (gastrointestinal and skeletal muscle stapling), gynecologic, urologic, and thoracic surgical procedures.

Product codes (comma separated list FDA assigned to the subject device)

GDW

Device Description

The Single Patient Use Transverse Cutter and Reload places four staggered curved row of titanium staples on the tissue upon activation, and cut the tissue between staple lines. The device is available in 40mm length with reload in 3.8mm and 4.5mm staple size. The device may be reloaded and fired up to 5 times in a single procedure.

Single Use Circular stapler places a double staggered, circular row of titanium staples upon activation, which was achieved by squeezing the handles firmly as far as they could go. Immediately after formation of the staples, the excess tissue will be resect by the circular knife, and then a circular anastomosis is created. The stapler are available in 21mm, 29mm, 32mm and 34mm six specifications. The staple sizes are 4.8mm and 5.5mm.

Single Patient Use Endo Cutter and Reload places two, triple-staggered rows of titanium staples and simultaneously divides the tissue from central line. The devices are available in 30mm, 45mm and 60mm three lengths. Reloads are available in six staple sizes to accommodate various tissue thicknesses: 2.0mm, 2.5mm, 3.5mm, 3.8mm, 4.1mm, 4.2mm. The device may be reloaded and fired up to 5 times in a single procedure.

Single Patient Use Linear Stapler and Reload places a double staggered row of titanium staples and is available in 30mm, 45mm, 60mm, 75mm and 90mm staple for use in various applications. Three staple sizes (2.5mm, 3.8mm and 4.5mm) are available to accommodate various tissue thicknesses. It may be reloaded and fired up to 4 times for a total 5 firing in a single procedure.

Single Patient Use Linear Cutter and Reload place two double staggered rows of titanium staples and simultaneously cut and divides tissue between the two double rows. The devices are available in 55mm, 60mm, 75mm, 80mm and 100mm lengths. Reloads are available in four staple sizes to accommodate various tissue thicknesses: 2.5mm, 4.2mm and 4.5mm. It may be reloaded and fired up to 4 times for a total 5 firings in a single procedure.

Single Use Hemorrhoidal Circular Stapler is a set of instruments that place a double staggered, circular row of titanium staples. Immediately after the formation of staples, the circular knife blade resects the excess of compressed mucosa. The stapler are available in 30mm, 34mm and 36mm four specifications. The staple size is 4.5mm. It cannot be reloaded.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

alimentary tract, general, gynecologic, thoracic, pediativ, abdominal, anal canal

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)

Non clinical tests were conducted to verify that the proposed device met all design specifications as was Substantially Equivalent (SE) to the predicate device. The test results demonstrated that the proposed device complies with the following standards:

  • ISO 10993-1:2009 Biological evaluation of medical devices- Part 1: Evaluation and testing within a risk management process.
  • ISO 10993-5:2009 Biological evaluation of medical devices-Part 5: Tests for in vitro cytotoxicity.
  • ISO 10993-10:2010 Biological evaluation of medical devices- Part 10: Test for irritation and delayed-type hypersensitivity
  • USP 38-NF 33 Bacterial Endotoxins Tests
  • ASTM F 88/F88M-09 Standard test method for seal strength of flexible barrier materials;
  • ISO 11137-2: 2013 Sterilization of health care products -Radiation- Part 2: Establishing the sterilization dose

No clinical study is included in this submission.

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

Not Found

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K030411, K983536, K020779, K111825, K061156, K062869

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

K080839, K112056

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 878.4750 Implantable staple.

(a)
Identification. An implantable staple is a staple-like device intended to connect internal tissues to aid healing. It is not absorbable.(b)
Classification. Class II.

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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 features the department's name in a circular arrangement around a symbol. The symbol consists of three stylized human profiles facing right, layered on top of each other. The profiles are connected by a flowing, ribbon-like shape.

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

February 9, 2017

TGS Medical Co., Ltd. % Ms. Diana Hong Mid-Link Consulting Co.,Ltd P.O. Box 120-119 Shanghai, 200120 China

Re: K162710

Trade/Device Name: Single Use Circular Stapler, Single Use Hemorrhodial Circular Stapler, Single Patient Use Linear Stapler And Reload, Single Patient Use Linear Cutter And Reload, Single Patient Use Endo Cutter And Reload, Single Patient Use Transverse Cutter And Reload

Regulation Number: 21 CFR 878.4750 Regulation Name: Implantable staple Regulatory Class: Class II Product Code: GDW Dated: January 6, 2017 Received: January 10, 2017

Dear Ms. Hong:

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 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.

Jennifer R. Stevenson -S

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

Enclosure

2

Indications for Use

510(k) Number (if known) K162710

K16271U

Device Name

Single Use Circular Stapler, Single Use Hemorrhodial Circular Stapler, Single Patient Use Linear Stapler and Reload, Single Patient Use Linear Cutter and Reload, Single Patient Use Endo Cutter and Reload, Single Patient Use Transverse Cutter and Reload

Indications for Use (Describe)

The Single Use Circular Stapler has application throughout the alimentary tract for end to side and side to side anastomoses.

The Single Patient Use Endo Cutter and Reload is intended for transection, and/or creation of anastomoses. The instrument has application in multiple open or minimally invasive general, gynecologic, thoracic, and pediativ surgical procedures. It can be used with tissue buttressing materials.

The Single Patient Use Linear Cutter and Reload are intended for use in multiple open or minimally invasive surgical procedures for the transection of tissues. Linear cutters are also intended for creation of anastomoses in these procedures.

The Single Patient Use Linear Stapler and Reload has applications in abdominal, gynecological, pediatric and thoracic surgical procedures for resection of tissue and creation of anastomosis, including occlusion of the left atrial appendage in open procedures. They may be used for transection and resection of pancreas.

The Single Use Hemorrhoidal Circular Stapler has application throughout the anal to perform surgical treatment of hemorrhoidal disease.

The Single Patient Use Transverse Cutter and Reload is intended for transection and or creation of anastomoses. The instrument has application in multiple open or minimally invasive general (gastrointestinal and skeletal muscle stapling), gynecologic, urologic, and thoracic surgical procedures.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

3

510(k) Summary

    1. Sponsor Identification

TGS Medical Co., Ltd.

Building 17, No.8 Jinfeng Road, High-tech Zone, Suzhou, Jiangsu Province, China

Establishment Registration Number: Not yet registered

Contact Person: Hua Cao Position: General Manager Tel: +86-512-86867776 Fax: +86- 512-86867070 Email: caohua@tgsmedical.com

    1. Designated Submission Correspondent
      Ms. Diana Hong (Primary Contact Person) Ms. Ying Xu (Alternative Contact Person)

Mid-Link Consulting Co., Ltd

P.O. Box 120-119, Shanghai, 200120, China

Tel: +86-21-22815850, Fax: 240-238-7587 Email: info@mid-link.net

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Identification of Proposed Device 3.

Trade Name: Single Use Circular Stapler

Single Use Hemorrhoidal Circular Stapler Single Patient Use Linear Stapler and Reload Single Patient Use Linear Cutter and Reload Single Patient Use Endo Cutter and Reload Single Patient Use Transverse Cutter and Reload

Common Name: Stapler and Reload

Regulatory Information Classification Name: Staple, Implantable Classification: II Product Code: GDW Regulation Number: 21CFR 878.4750 Review Panel: General& Plastic Surgery

Classification Name: Stapler, Surgical; Classification: I Exempt Regulation Number: 21CFR 878.4800 Review Panel: General & Plastic Surgery

Intended Use Statement:

The Single Use Circular Stapler has application throughout the alimentary tract for end to side and side to side anastomoses.

The Single Patient Use Endo Cutter and Reload is intended for transection, and/or creation of The instrument has application in multiple open or minimally invasive general, anastomoses. gynecologic, urologic, thoracic, and pediatric surgical procedures. It can be used with tissue buttressing materials.

The Single Patient Use Linear Cutter and Reload are intended for use in multiple open or surgical procedures for the transection of tissues. Linear cutters are also intended for creation of anastomoses in these procedures.

The Single Patient Use Linear Stapler and Reload has applications in abdominal, gynecological, pediatric and thoracic surgical procedures for resection of tissue and creation of

5

anastomosis, including occlusion of the left atrial appendage in open procedures. They may be used for transection and resection of pancreas.

The Single Use Hemorrhoidal Circular Stapler has application throughout the anal canal to perform surgical treatment of hemorrhoidal disease.

The Single Patient Use Transverse Cutter and Reload is intended for transection, resection and/or creation of anastomoses. The instrument has application in multiple open or general (gastrointestinal and skeletal muscle stapling), gynecologic, urologic, and thoracic surgical procedures.

Device Description

The Single Patient Use Transverse Cutter and Reload places four staggered curved row of titanium staples on the tissue upon activation, and cut the tissue between staple lines. The device is available in 40mm length with reload in 3.8mm and 4.5mm staple size. The device may be reloaded and fired up to 5 times in a single procedure.

Single Use Circular stapler places a double staggered, circular row of titanium staples upon activation, which was achieved by squeezing the handles firmly as far as they could go. Immediately after formation of the staples, the excess tissue will be resect by the circular knife, and then a circular anastomosis is created. The stapler are available in 21mm, 29mm, 32mm and 34mm six specifications. The staple sizes are 4.8mm and 5.5mm.

Single Patient Use Endo Cutter and Reload places two, triple-staggered rows of titanium staples and simultaneously divides the tissue from central line. The devices are available in 30mm, 45mm and 60mm three lengths. Reloads are available in six staple sizes to accommodate various tissue thicknesses: 2.0mm, 2.5mm, 3.5mm, 3.8mm, 4.1mm, 4.2mm. The device may be reloaded and fired up to 5 times in a single procedure.

Single Patient Use Linear Stapler and Reload places a double staggered row of titanium staples and is available in 30mm, 45mm, 60mm, 75mm and 90mm staple for use in various applications. Three staple sizes (2.5mm, 3.8mm and 4.5mm) are available to accommodate various tissue thicknesses. It may be reloaded and fired up to 4 times for a total 5 firing in a single procedure.

Single Patient Use Linear Cutter and Reload place two double staggered rows of titanium staples and simultaneously cut and divides tissue between the two double rows. The devices are available in 55mm, 60mm, 75mm, 80mm and 100mm lengths. Reloads are available in four staple sizes to accommodate various tissue thicknesses: 2.5mm, 4.2mm and 4.5mm. It may be reloaded and fired up to 4 times for a total 5 firings in a single procedure.

6

Single Use Hemorrhoidal Circular Stapler is a set of instruments that place a double staggered, circular row of titanium staples. Immediately after the formation of staples, the circular knife blade resects the excess of compressed mucosa. The stapler are available in 30mm, 34mm and 36mm four specifications. The staple size is 4.5mm. It cannot be reloaded.

    1. Identification of Predicate Devices
      Predicate Device 1 510(k) Number: K030411 Product Name: PROXIMATE® PPH Hemorrhoidal Circular Stapler and Accessories

Predicate Device 2 510(k) Number: K983536 Product Name: PROXIMATE® Curved and Straight Intraluminal Staplers

Predicate Device 3 510(k) Number: K020779 Product Name: ENDOPATH and PROXIMATE Linear Cutters and Staplers

Predicate Device 4 510(k) Number: K111825 Product Name: DST Series™ Staplers

Predicate Device 5 510(k) Number: K061156 Product Name: ENDOPATH Linear Cutters and Staplers

Predicate Device 6 510(k) Number: K062869 Product Name: CONTOUR™ Curved Cutter Stapler and Reloads

  • న. Identification of Reference Devices
    Reference Device 1 510(k) Number: K080839 Product Name: Echelon™ Gray Cartridge-45mm

Reference Device 2 510(k) Number: K112056 Product Name: Echelon Endoscopic Linear Cutter Reload, Black

7

6. Non-Clinical Test Conclusion

Non clinical tests were conducted to verify that the proposed device met all design specifications as was Substantially Equivalent (SE) to the predicate device. The test results demonstrated that the proposed device complies with the following standards:

  • ISO 10993-1:2009 Biological evaluation of medical devices- Part 1: Evaluation and testing within a risk management process.

  • ISO 10993-5:2009 Biological evaluation of medical devices-Part 5: Tests for in vitro cytotoxicity.

  • ISO 10993-10:2010 Biological evaluation of medical devices- Part 10: Test for irritation and delayed-type hypersensitivity

  • USP 38-NF 33 Bacterial Endotoxins Tests

  • ASTM F 88/F88M-09 Standard test method for seal strength of flexible barrier materials;

  • ISO 11137-2: 2013 Sterilization of health care products -Radiation- Part 2: Establishing the sterilization dose

    1. Clinical Test Conclusion

No clinical study is included in this submission.

8

8. Substantially Equivalent (SE) Comparison

ItemProposed DevicePredicate Device 6
Product CodeGDWK062869
Regulation Number21 CFR 878.4750Same
Intended UseThe Single Patient Use Transverse Cutter and Reload is intended for transection, resection and/or creation of anastomoses. The instrument has application in multiple open or general (gastrointestinal and skeletal muscle stapling), gynecologic, urologic, and thoracic surgical procedures.Same
Cutting MechanismCurved KnifeSame
Operation PrincipleManualSame
Safety MechanismReset Knob is used for preventing from mis-firingSame
Closed staple height1.5mm, 2.0mmSame
Closed staple formImage: staple formImage: staple form
Patient-contact materialUnalloyed Titanium
Polycarbonate
Stainless SteelUnknown
SterilizationIrradiation SterilizationEO Sterilization
Endotoxin Limit20 EUSame
LabelingConforms with 21 CFR 801Same

Table 1 Comparison of Technology Characteristics for Single Patient Use Transverse Cutter and Reload

9

ItemProposed DevicePredicate Device 2ItemProposed DevicePredicateReferenceReferenceItemProposed DevicePredicate Device 4
K983536Device 5
K061156Device 1
K080839Device 2
K112056Product CodeGDWK111825
Product CodeGDWSameProduct CodeGDWSameSameSameRegulation Number21 CFR 878.4750Same
Regulation Number21 CFR 878.4750SameRegulation
Number21 CFR 878.4750SameSameSameIntended UseThe Single Patient Use Linear Stapler
and Reload has applications in
abdominal, gynecological, pediatric
and thoracic surgical procedures for
resection or transection of tissue and
creation of anastomosis, including
occlusion of the left atrial appendage
in open procedures. They may be
used for transection and resection of
pancreas.Same
Intended UseThe Single Use Circular Stapler has
application throughout the alimentary
tract for end to end, end to side and
side to side anastomoses.SameIntended UseThe Single Patient Use Endo Cutter
and Reload is intended for
transection, resection, and/or
creation of anastomoses. The
instrument has application in
multiple open or minimally invasive
general, gynecologic, urologic,
thoracic, and pediatric surgical
procedures.SameSameSameCutting MechanismN.A.Same
Cutting MechanismCircular KnifeSameCutting
MechanismLinear KnifeSameSameSameOperation PrincipleManualSame
Operation PrincipleManualSameOperation
PrincipleManualSameSameSameSafety MechanismSafety release for preventing from
mis-firingSame
Safety MechanismInsurance is used for preventing from
mis-firingSameSafety
MechanismGreen button for preventing from
mis-firingSameSameSameClosed staple height1.0mm, 1.5mm, 2.0mmSame
Closed staple height1.0~2.5mmSameClosed staple
height0.75, 1.0, 1.5, 1.8, 2.0, 2.3mm1.0, 1.5,
1.8, 2.0mm0.75mm2.3mmClosed staple formImage: staple formImage: staple form
Closed staple formImage: staple formImage: staple formClosed staple
formImage: staple formImage: staple formImage: staple formImage: staple formPatient-contact
materialUnalloyed Titanium
Polycarbonate
Stainless SteelUnknown
Patient-contact
materialUnalloyed Titanium
Polycarbonate
Stainless SteelUnknownPatient-contact
materialUnalloyed Titanium
Acrylonitrile-Butadiene-Styrene
Stainless SteelUnknownUnknownUnknownSterilizationIrradiation SterilizationEO Sterilization
SterilizationIrradiation SterilizationEO SterilizationSterilizationIrradiation SterilizationEO
SterilizationEO
SterilizationEO
SterilizationEndotoxin Limit20 EUSame
Endotoxin Limit20 EUSameEndotoxin
Limit20 EUSameSameSameLabelingConforms with 21 CFR 801Same
LabelingConforms with 21 CFR 801SameLabelingConforms with 21 CFR 801SameSameSame

Table 2 Comparison of Technology Characteristics for Single Use Circular Stapler

10

Table 3 Comparison of Technology Characteristics for Single Patient Use Endo Cutter and Reload

11

Table 4 Comparison of Technology Characteristics for Single Patient Use Linear Stapler and Reload

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ItemProposed DevicePredicate Device 3
Product CodeGDWK020779
Regulation Number21 CFR 878.4750Same
Intended UseThe Single Patient Use Linear Cutter
and Reload are intended for use in
multiple open or surgical procedures
for the transection and resection of
tissues. Linear cutters are also
intended for creation of anastomoses
in these procedures.Same
Cutting MechanismLinear KnifeSame
Operation PrincipleManualSame
Safety MechanismSafety release for preventing from
mis-firingSame
Closed staple height1.0mm, 1.5mm, 1.8mm, 2.0mmSame
Closed staple formImage: staple formImage: staple form
Patient-contact
materialUnalloyed Titanium
Polycarbonate
Stainless SteelUnknown
SterilizationIrradiation SterilizationEO Sterilization
Endotoxin Limit20 EUSame
LabelingConforms with 21 CFR 801Same

Table 5 Comparison of Technology Characteristics for Single Patient Use Linear Cutter and Reload

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ItemProposed DevicePredicate Device 1
Product CodeGDWK030411
Regulation Number21 CFR 878.4750Same
Intended UseThe Single Use Hemorrhoidal Circular Stapler has application throughout the anal canal to perform surgical treatment of hemorrhoidal disease.Same
Cutting MechanismCircular KnifeSame
Operation PrincipleManualSame
Safety MechanismSafety release for preventing from mis-firingSame
Closed staple height0.8~2.0mmSame
Closed staple formImage: staple formImage: staple form
Patient-contact materialUnalloyed Titanium
Polycarbonate
Stainless SteelUnknown
SterilizationIrradiation SterilizationEO Sterilization
Endotoxin Limit20 EUSame
LabelingConforms with 21 CFR 801Same

Table 6 Comparison of Technology Characteristics for Single Use Hemorrhoidal Circular Stapler

Substantially Equivalent (SE) Conclusion 9.

Based on the comparison and analysis above, the proposed devices are determined to be Substantially Equivalent (SE) to the predicate devices.