K Number
K163009
Device Name
Litho
Manufacturer
Date Cleared
2016-12-01

(34 days)

Product Code
Regulation Number
878.4810
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Litho laser system and its fiber optic delivery system are in surgical procedures using open. laparoscopic and endoscopic incision. resection. ablation. vaporization, coagulation and haemostasis of soft tissue in use in medical specialties including: Urinary Lithotripsy, Gastroenterology, Arthroscopy, Discectonly, Gynaecology. ENT and General Surgery. Urology Open and endoscopic surgery (incision, excision, resection, ablation. vaporization, coagulation and haemostasis) including: - · Urethral Strictures - · Bladder Neck Incisions (BNI) - · Ablation and resection of Bladder Tumors. Uretheral Tumors and Ureteral · Tumors, - · Ablation of Benign Prostatic Hypertrophy (BHP), - · Transurethral incision of the prostate (TUIP) - · Holmium Laser Resection of the Prostrate (HoLRP) - · Holmium Laser Enucleation of the Prostate (HoLEP) - · Holmium laser Ablation of the Prostate (HoLAP) - · Condylomas - Lesions of external genitalia Lithotripsy and Percutaneous Urinary Lithotripsy · Endoscopic fragmentation of urethral. ureteral. bladder and renal calculi including cystine, calcium oxalate. monohydrate and calcium oxalate · dehydrate stones. - · Endoscopic fragmentation of kidney calculi - · Treatment of distal impacted fragments of steinstrasse when guide wire cannot be passed. Gastroenterology Open and endoscopic Gastroenterology surgery (incision, excision. resection. ablation, vaporization, coagulation and haemostasis) including: - · Appendectomy - Polyps - · Biopsy - Gall Bladder calculi - · Biliary/Bile duct calculi - Ulcers - Gastric ulcers - · Duodenal ulcers - · Non Bleeding Ulcers - Pancreatitas - Haemorrhoids - Cholecystectomy - · Benign and Malignant Neoplasm - Angiodysplasia - Colorectal cancer - Telangiectasias - · Telangiectasias of the Osler-Weber-Renu disease - Vascular Malformation - · Gastritis - · Esophagitis - · Esophageal ulcers - Varices - Colitis - · Mallory-Weiss tear - · Gastric Erosions Arthroscopy Arthroscopy/Orthopaedic surgery (excision, ablation and coagulation of soft and cartilaginous tissue) in small and large joints of the body, excluding the spine but including: - · Ligament and tendon Release - Contouring and sculpting of articular surfaces - · Capsulectomy in the Knee - Chondreplasty in the Knee - Debridement of inflamed synovial tissue - Chondromalacia Ablation - · Chondromalacia and tears - Plica Removal - Meniscectomy - Loose Body Debridement - Lateral retinecular release Ablation of soft, cartilaginous and bony tissue in Minimal Invasive Spinal Surgery including - · Percutaneous Laser Disc Decompression/Discectomy of the L4-5 and L5-SI lumbar discs, including Foraminoplasty Percutaneous Cervical Disc Decompression/Discectomy - Percutaneous Thoracic Disc Decompression/Discectorny Gynaecology Open and laparoscopic gynaecological surgery (incision, resection, ablation, vaporization, coagulation and haemostasis) of soft tissue ENT Endoscopic endonasal surgery (incision, resection, ablation, vaporization, coagulation and haemostasis of soft tissue and cartilage) including: - Endonasal/sinus Surgery - · Partial turbinectomy - Polypectomy - Dacryocystorhinostomy - · Frontal Sinusotomy - · Ethmoidectomy - Maxillary antrostomy - · Functional endoscopic sinus surgery General Surgery Open. laparoscopic and endoscopic surgery (incision. resection. ablation, vaporization, coagulation and haemostasis) including: - · Appendectomy - Skin incision - Excision of external and internal lesions - · Complete of partial resection of internal organs, tumors and lesions - · Biopsy
Device Description
This Special 510(k) of the modified device Litho is submitted due to Device Modifications of the already cleared device (K141101) due to the broadening of the range of some laser emission parameters such as power, energy and frequency. The modified device has the same intended use of the unmodified device. Moreover the the intended use of the modified device, as described in its labeling, has not changed as a result of the modifications. The modified and unmodified devices are exactly the same except for the available range of emission parameters. A change to the software determined the differences between the modified and unmodified versions.
More Information

Not Found

No
The document describes a laser system for surgical procedures and mentions software changes related to laser emission parameters. There is no mention of AI, ML, or any capabilities that would suggest the use of such technologies for image processing, diagnosis, or other functions.

Yes
The device is used for a variety of surgical procedures, including incision, resection, ablation, vaporization, coagulation, and haemostasis of soft tissue, addressing conditions in multiple medical specialties. These procedures are aimed at treating or alleviating medical conditions, which aligns with the definition of a therapeutic device.

No

The device description indicates its use in surgical procedures for incision, resection, ablation, vaporization, coagulation, and haemostasis of soft tissue, which are all therapeutic actions. There is no mention of it being used to diagnose conditions or diseases.

No

The device description explicitly states it is a "Litho laser system and its fiber optic delivery system," indicating it is a hardware device that uses software to control its parameters. The modifications are to the laser emission parameters, which are hardware-controlled functions.

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 surgical laser system used for procedures like incision, resection, ablation, vaporization, coagulation, and haemostasis of soft tissue and calculi within the body. These are all in vivo procedures, meaning they are performed on living tissue within the patient.
  • IVD Definition: In vitro diagnostics are tests performed on samples taken from the human body (like blood, urine, or tissue) to detect diseases, conditions, or infections. The Litho laser system does not perform such tests.
  • Device Description: The device description confirms it's a laser system with a fiber optic delivery system, designed for surgical intervention.
  • Lack of IVD-related information: The document does not mention any analysis of biological samples, diagnostic testing, or any of the typical components or processes associated with IVD devices.

Therefore, the Litho laser system is a surgical device, not an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

The Litho laser system and its fiber optic delivery system are in surgical procedures using open. laparoscopic and endoscopic incision. resection. ablation. vaporization, coagulation and haemostasis of soft tissue in use in medical specialties including: Urinary Lithotripsy, Gastroenterology, Arthroscopy, Discectonly, Gynaecology. ENT and General Surgery.

Urology
Open and endoscopic surgery (incision, excision, resection, ablation.
vaporization, coagulation and haemostasis) including:

  • · Urethral Strictures
  • · Bladder Neck Incisions (BNI)
  • · Ablation and resection of Bladder Tumors. Uretheral Tumors and Ureteral · Tumors,
  • · Ablation of Benign Prostatic Hypertrophy (BHP),
  • · Transurethral incision of the prostate (TUIP)
  • · Holmium Laser Resection of the Prostrate (HoLRP)
  • · Holmium Laser Enucleation of the Prostate (HoLEP)
  • · Holmium laser Ablation of the Prostate (HoLAP)
  • · Condylomas
  • Lesions of external genitalia

Lithotripsy and Percutaneous Urinary Lithotripsy
· Endoscopic fragmentation of urethral. ureteral. bladder and renal calculi including cystine, calcium oxalate.
monohydrate and calcium oxalate
· dehydrate stones.

  • · Endoscopic fragmentation of kidney calculi
  • · Treatment of distal impacted fragments of steinstrasse when guide wire cannot be passed.

Gastroenterology
Open and endoscopic Gastroenterology surgery (incision, excision. resection. ablation, vaporization, coagulation and haemostasis) including:

  • · Appendectomy
  • Polyps
  • · Biopsy
  • Gall Bladder calculi
  • · Biliary/Bile duct calculi
  • Ulcers
  • Gastric ulcers
  • · Duodenal ulcers
  • Non Bleeding Ulcers
  • Pancreatitas
  • Haemorrhoids
  • Cholecystectomy
  • · Benign and Malignant Neoplasm
  • Angiodysplasia
  • Colorectal cancer
  • Telangiectasias
  • · Telangiectasias of the Osler-Weber-Renu disease
  • Vascular Malformation
  • · Gastritis
  • · Esophagitis
  • · Esophageal ulcers
  • Varices
  • Colitis
  • · Mallory-Weiss tear
  • · Gastric Erosions

Arthroscopy
Arthroscopy/Orthopaedic surgery (excision, ablation and coagulation of soft and cartilaginous tissue) in small and large joints of the body, excluding the spine but including:

  • · Ligament and tendon Release
  • Contouring and sculpting of articular surfaces
  • · Capsulectomy in the Knee
  • Chondreplasty in the Knee
  • Debridement of inflamed synovial tissue
  • Chondromalacia Ablation
  • · Chondromalacia and tears
  • Plica Removal
  • Meniscectomy
  • Loose Body Debridement
  • Lateral retinecular release

Ablation of soft, cartilaginous and bony tissue in Minimal Invasive Spinal Surgery including

  • · Percutaneous Laser Disc Decompression/Discectomy of the L4-5 and L5-SI lumbar discs, including Foraminoplasty Percutaneous Cervical Disc Decompression/Discectomy
    • Percutaneous Thoracic Disc Decompression/Discectorny

Gynaecology
Open and laparoscopic gynaecological surgery (incision, resection, ablation, vaporization, coagulation and haemostasis) of soft tissue

ENT
Endoscopic endonasal surgery (incision, resection, ablation, vaporization, coagulation and haemostasis of soft tissue and cartilage) including:

  • Endonasal/sinus Surgery
  • · Partial turbinectomy
  • Polypectomy
  • Dacryocystorhinostomy
  • Frontal Sinusotomy
  • · Ethmoidectomy
  • Maxillary antrostomy
  • · Functional endoscopic sinus surgery

General Surgery
Open. laparoscopic and endoscopic surgery (incision. resection. ablation, vaporization, coagulation and haemostasis) including:

  • · Appendectomy
  • Skin incision
  • Excision of external and internal lesions
  • · Complete of partial resection of internal organs, tumors and lesions
  • · Biopsy

Product codes

GEX

Device Description

This Special 510(k) of the modified device Litho is submitted due to Device Modifications of the already cleared device (K141101) due to the broadening of the range of some laser emission parameters such as power, energy and frequency.

The modified device has the same intended use of the unmodified device. Moreover the the intended use of the modified device, as described in its labeling, has not changed as a result of the modifications.

The modified and unmodified devices are exactly the same except for the available range of emission parameters. A change to the software determined the differences between the modified and unmodified versions.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Urethra, Bladder, Ureter, Prostate, External genitalia, Urethral, Bladder, Renal calculi (cystine, calcium oxalate monohydrate, calcium oxalate dehydrate stones), Kidney, Appendix, Colon (Polyps), Gallbladder, Biliary/Bile duct, Stomach (Ulcers, Gastric ulcers, Erosions), Duodenum (Duodenal ulcers), Pancreas, Hemorrhoids, Angiodysplasia (Gastrointestinal), Colorectal, Telangiectasias (including Osler-Weber-Rendu disease), Vascular Malformation (Gastrointestinal), Esophagus (Esophagitis, Esophageal ulcers, Varices), Colon, Mallory-Weiss tear, Joints (small and large, excluding spine), Ligaments, Tendons, Articular surfaces, Knee (Capsule, Chondroplasty, Synovial tissue, Chondromalacia, Plica), Meniscus, Lumbar discs (L4-5, L5-SI), Cervical discs, Thoracic discs, Female reproductive organs, Nasal cavity, Sinuses (Endonasal/sinus), Turbinates, Lacrimal sac/nasal cavity connection (Dacryocystorhinostomy), Frontal sinus, Ethmoid sinus, Maxillary sinus, Skin, Internal organs

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)

The modified device Litho was subjected to performance testing in accordance with the following recognized consensus standards related to electromagnetic compatibility, electrical safety and performances:

  • IEC 60601-1:2012. Medical Electrical Equipment Part 1: General Requirements For -Basic Safety And Essential Performance
  • -IEC 60601-1-2 Edition 3: 2007-03, Medical Electrical Equipment - Part 1-2: General Requirements For Basic Safety And Essential Performance - Collateral Standard: Electromagnetic Compatibility - Requirements And Tests.
  • -IEC 60601-2-22 Third Edition 2007-05, Medical Electrical Equipment - Part 2-22: Particular Requirements For Basic Safety And Essential Performance Of Surgical, Cosmetic, Therapeutic And Diagnostic Laser Equipment
  • . IEC 60825-1 Edition 2.0 2007-03, Safety Of Laser Products Part 1: Equipment Classification, And Requirements

The modified device Litho passed all the required testing and is in compliance will all applicable sections of the above mentioned performance standards.

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

Not Found

Predicate Device(s)

K141101, K140388

Reference Device(s)

Not Found

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

§ 878.4810 Laser surgical instrument for use in general and plastic surgery and in dermatology.

(a)
Identification. (1) A carbon dioxide laser for use in general surgery and in dermatology is a laser device intended to cut, destroy, or remove tissue by light energy emitted by carbon dioxide.(2) An argon laser for use in dermatology is a laser device intended to destroy or coagulate tissue by light energy emitted by argon.
(b)
Classification. (1) Class II.(2) Class I for special laser gas mixtures used as a lasing medium for this class of lasers. 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 § 878.9.

0

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

DEPARTMENT OF HEALTH & HUMAN SERVICES - USA

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

March 16, 2018

Ouanta System S.p.A. Francesco Dell'antonio V.P Regulatory Affairs & Quality Assurance Via acquedotto. 109 Samarate, 20826 Italy

Re: K163009

Trade/Device Name: Litho Regulation Number: 21 CFR 878.4810 Regulation Name: Laser Surgical Instrument For Use In General And Plastic Surgery And In Dermatology Regulatory Class: Class II Product Code: GEX Dated: November 3, 2016 Received: November 4, 2016

Dear Francesco Dell'antonio:

This letter corrects our substantially equivalent letter of December 1, 2016.

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.

1

Page 2 - Francesco Dell'antonio

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 devicerelated 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 -S3

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

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 below.

510(k) Number (if known) K163009

Device Name Litho

Indications for Use (Describe)

The Litho laser system and its fiber optic delivery system are in surgical procedures using open. laparoscopic and endoscopic incision. resection. ablation. vaporization, coagulation and haemostasis of soft tissue in use in medical specialties including: Urinary Lithotripsy, Gastroenterology, Arthroscopy, Discectonly, Gynaecology. ENT and General Surgery.

Urology

Open and endoscopic surgery (incision, excision, resection, ablation.

vaporization, coagulation and haemostasis) including:

  • · Urethral Strictures
  • · Bladder Neck Incisions (BNI)
  • · Ablation and resection of Bladder Tumors. Uretheral Tumors and Ureteral · Tumors,
  • · Ablation of Benign Prostatic Hypertrophy (BHP),
  • · Transurethral incision of the prostate (TUIP)
  • · Holmium Laser Resection of the Prostrate (HoLRP)
  • · Holmium Laser Enucleation of the Prostate (HoLEP)
  • · Holmium laser Ablation of the Prostate (HoLAP)
  • · Condylomas
  • Lesions of external genitalia

Lithotripsy and Percutaneous Urinary Lithotripsy

· Endoscopic fragmentation of urethral. ureteral. bladder and renal calculi including cystine, calcium oxalate.

monohydrate and calcium oxalate

· dehydrate stones.

  • · Endoscopic fragmentation of kidney calculi
  • · Treatment of distal impacted fragments of steinstrasse when guide wire cannot be passed.

Gastroenterology

Open and endoscopic Gastroenterology surgery (incision, excision. resection. ablation, vaporization, coagulation and haemostasis) including:

  • · Appendectomy
  • Polyps
  • · Biopsy
  • Gall Bladder calculi
  • · Biliary/Bile duct calculi
  • Ulcers
  • Gastric ulcers
  • · Duodenal ulcers

FORM FDA 3881 (1/14)

3

· Non Bleeding Ulcers

  • Pancreatitas
  • Haemorrhoids
  • Cholecystectomy
  • · Benign and Malignant Neoplasm
  • Angiodysplasia
  • Colorectal cancer
  • Telangiectasias
  • · Telangiectasias of the Osler-Weber-Renu disease
  • Vascular Malformation
  • · Gastritis
  • · Esophagitis
  • · Esophageal ulcers
  • Varices
  • Colitis
  • · Mallory-Weiss tear
  • · Gastric Erosions

Arthroscopy

Arthroscopy/Orthopaedic surgery (excision, ablation and coagulation of soft and cartilaginous tissue) in small and large joints of the body, excluding the spine but including:

  • · Ligament and tendon Release
  • Contouring and sculpting of articular surfaces
  • · Capsulectomy in the Knee
  • Chondreplasty in the Knee
  • Debridement of inflamed synovial tissue
  • Chondromalacia Ablation
  • · Chondromalacia and tears
  • Plica Removal
  • Meniscectomy
  • Loose Body Debridement
  • Lateral retinecular release

Ablation of soft, cartilaginous and bony tissue in Minimal Invasive Spinal Surgery including

  • · Percutaneous Laser Disc Decompression/Discectomy of the L4-5 and L5-SI lumbar discs, including Foraminoplasty Percutaneous Cervical Disc Decompression/Discectomy
    • Percutaneous Thoracic Disc Decompression/Discectorny

Gynaecology

Open and laparoscopic gynaecological surgery (incision, resection, ablation, vaporization, coagulation and haemostasis) of soft tissue

ENT

Endoscopic endonasal surgery (incision, resection, ablation, vaporization, coagulation and haemostasis of soft tissue and cartilage) including:

  • Endonasal/sinus Surgery
  • · Partial turbinectomy
  • Polypectomy
  • Dacryocystorhinostomy

FORM FDA 3881 (1/14)

4

· Frontal Sinusotomy

  • · Ethmoidectomy
  • Maxillary antrostomy
  • · Functional endoscopic sinus surgery

General Surgery

Open. laparoscopic and endoscopic surgery (incision. resection. ablation, vaporization, coagulation and haemostasis) including:

  • · Appendectomy
  • Skin incision
  • Excision of external and internal lesions
  • · Complete of partial resection of internal organs, tumors and lesions
  • · Biopsy

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

2 Prescription Use (Part 21 CFR 801 Subpart D)

ا_ 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."

5

5. Special 510(K) SUMMARY – Device Modifications

Introduction:

This document contains the 510(k) Summary for the device Litho. The basis of this submission is Modifications to a Device already cleared. The content of this summary is based on the requirements of 21 CFR 807.92(c).

| Applicant / Manufacturer Name and Address: | Quanta System SPA
Via Acquedotto, 109
Samarate (VA)
Italy, 21017 |
|--------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 510(k) Contact Person: | Francesco Dell'Antonio
Vice President Regulatory Affairs and QA
Quanta System SPA
Email: francesco.dellantonio@quantasystem.com
Phone: +39-0331-376797
Fax: +39-0331-367815 |
| Date Prepared: | October 26 th 2016 |
| Device Name: | Litho |
| Classification: | Class II |
| Classification Name: | Laser surgical instrument for use in general and plastic
surgery and in dermatology. |
| Regulation Number: | 21 CFR 878.4810 |
| Product Code: | GEX |
| Basis for Submission: | Device modifications |
| Legally Marketed Device | Litho (K141101) - Quanta System SPA
Lumenis Pulse 120h (K140388) - Lumenis LTD |

Performance Standards:

There are no mandatory performance standards for this device.

6

Description of the modifications:

This Special 510(k) of the modified device Litho is submitted due to Device Modifications of the already cleared device (K141101) due to the broadening of the range of some laser emission parameters such as power, energy and frequency.

The modified device has the same intended use of the unmodified device. Moreover the the intended use of the modified device, as described in its labeling, has not changed as a result of the modifications.

The modified and unmodified devices are exactly the same except for the available range of emission parameters. A change to the software determined the differences between the modified and unmodified versions.

There are not incremental changes from the original clearance K141101 to be taken into account other than the differences between modified and unmodified devices.

Based on the nature of the changes implemented, the device underwent and successfully passed electrical safety and performance testing according to IEC 60601-1 and its collateral standards.

Intended Use/Indications for Use

The modified device Litho has the same intended use of the unmodified device, as follows:

The LITHO laser system and its fiber optic delivery system are intended for use in surgical procedures using open, laparoscopic and endoscopic incision, resection, ablation, vaporization, coaqulation and haemostasis of soft tissue in medical specialties including: Urology, Urinary Lithotripsy, Gastroenterology, Arthroscopy, Discectomy, Gynaecology, ENT and General Surgery.

Urology

Open and endoscopic surgery (incision, excision, resection, ablation,

vaporization, coagulation and haemostasis) including:

  • . Urethral Strictures
  • Bladder Neck Incisions (BNI) .
  • Ablation and resection of Bladder Tumors, Uretheral Tumors and Ureteral Tumors, .
  • . Ablation of Benign Prostatic Hypertrophy (BHP),
  • . Transurethral incision of the prostate (TUIP)
  • . Holmium Laser Resection of the Prostrate (HoLRP)
  • Holmium Laser Enucleation of the Prostate (HoLEP) .
  • Holmium laser Ablation of the Prostate (HoLAP) ●
  • Condylomas .
  • Lesions of external genitalia .

Lithotripsy and Percutaneous Urinary Lithotripsy

5-2

7

  • . Endoscopic fragmentation of urethral. ureteral, bladder and renal calculi including cystine, calcium oxalate, monohydrate and calcium oxalate
  • dehydrate stones. ●
  • Endoscopic fragmentation of kidney calculi
  • . Treatment of distal impacted fragments of steinstrasse when guide wire cannot be passed.

Gastroenterology

Open and endoscopic Gastroenterology surgery (incision, excision, resection, ablation, vaporization, coagulation and haemostasis) including:

  • . Appendectomy
  • Polvps .
  • Biopsy ●
  • . Gall Bladder calculi
  • Biliary/Bile duct calculi .
  • Ulcers .
  • Gastric ulcers .
  • . Duodenal ulcers
  • Non Bleeding Ulcers .
  • . Pancreatitas
  • Haemorrhoids
  • Cholecystectomy .
  • Benign and Malignant Neoplasm
  • Angiodysplasia .
  • . Colorectal cancer
  • o Telangiectasias
  • Telangiectasias of the Osler-Weber-Renu disease .
  • Vascular Malformation .
  • Gastritis .
  • Esophagitis .
  • Esophageal ulcers .
  • Varices .
  • Colitis ●
  • Mallory-Weiss tear .
  • Gastric Erosions .

Arthroscopy

Arthroscopy/Orthopaedic surgery (excision, ablation and coagulation of soft and cartilaginous tissue) in small and large joints of the body, excluding the spine but including:

ર-3

8

  • Ligament and tendon Release .
  • Contouring and sculpting of articular surfaces .
  • Capsulectomy in the Knee .
  • Chondreplasty in the Knee .
  • . Debridement of inflamed synovial tissue
  • Chondromalacia Ablation .
  • Chondromalacia and tears ●
  • Plica Removal .
  • Meniscectomy . .
  • . Loose Body Debridement
  • . Lateral retinecular release

Ablation of soft, cartilaginous and bony tissue in Minimal Invasive Spinal Surgery including

  • Percutaneous Laser Disc Decompression/Discectomy of the L4-5 and L5-SI lumbar . discs. including Foraminoplasty Percutaneous Cervical Disc Decompression/Discectomy Percutaneous Thoracic Disc Decompression/Discectomy

Gynaecology

Open and laparoscopic gynaecological surgery (incision, excision, resection, ablation, vaporization, coagulation and haemostasis) of soft tissue

ENT

Endoscopic endonasal surgery (incision, excision, resection, ablation, vaporization, coagulation and haemostasis of soft tissue and cartilage) including:

  • . Endonasal/sinus Surgery
  • Partial turbinectomy .
  • . Polypectomy
  • . Dacrvocystorhinostomy
  • Frontal Sinusotomy ●
  • Ethmoidectomy .
  • . Maxillary antrostomy
  • Functional endoscopic sinus surgery .

General Surgery

Open, laparoscopic and endoscopic surgery (incision, resection, ablation, vaporization, coagulation and haemostasis) including:

  • . Appendectomy
  • Skin incision .
  • Excision of external and internal lesions .
  • Complete of partial resection of internal organs, tumors and lesions .
  • Biopsy .

9

Substantial Equivalence:

The modified and unmodified devices have the same components, the same laser sources and the same controlling principles, but some differences in the range of emission parameters.

Another predicate device, Lumenis Pulse 120h (K140388), has been considered in order to demonstrate the safety and effectiveness of the parameters combinations not included in the unmodified device.

The modified and unmodified devices have the same intended use.

Thus the modified device Litho is substantially equivalent to the previously legally marketed device, cleared under K141101.

Performace testing

The modified device Litho was subjected to performance testing in accordance with the following recognized consensus standards related to electromagnetic compatibility, electrical safety and performances:

  • IEC 60601-1:2012. Medical Electrical Equipment Part 1: General Requirements For -Basic Safety And Essential Performance
  • -IEC 60601-1-2 Edition 3: 2007-03, Medical Electrical Equipment - Part 1-2: General Requirements For Basic Safety And Essential Performance - Collateral Standard: Electromagnetic Compatibility - Requirements And Tests.
  • -IEC 60601-2-22 Third Edition 2007-05, Medical Electrical Equipment - Part 2-22: Particular Requirements For Basic Safety And Essential Performance Of Surgical, Cosmetic, Therapeutic And Diagnostic Laser Equipment
  • . IEC 60825-1 Edition 2.0 2007-03, Safety Of Laser Products Part 1: Equipment Classification, And Requirements

The modified device Litho passed all the required testing and is in compliance will all applicable sections of the above mentioned performance standards.