K Number
K171825
Date Cleared
2018-02-13

(239 days)

Product Code
Regulation Number
878.4400
Reference & Predicate Devices
Predicate For
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

Endoscopic Instruments are designed to cut, dissect, manipulate and/or cauterize various tissues during endoscopic/ laparoscopic, general surgical procedures.

Device Description

Endoscopic Surgical Instrument is a kind of device used to cut, dissect, manipulate and/or cauterize various tissues during endoscopic/laparoscopic, general surgical procedures. The device includes Disposable Endoscopic Surgical Instrument and Reusable Endoscopic Surgical Instrument. Both of the disposable and reusable endoscopic instruments are provided sterile when they're released. After used for the first time, Reusable Endoscopic Instrument needs to be sterilized by the end users. The instruments are 5mm in diameter as well as 340mm in length.

AI/ML Overview

Here's a breakdown of the acceptance criteria and study information based on the provided document:

1. Table of Acceptance Criteria and Reported Device Performance

The document does not explicitly state acceptance criteria in a quantitative format for specific performance metrics that would typically be found in an Acceptance Criteria table. Instead, it refers to compliance with international standards and internal design control procedures.

However, based on the non-clinical testing performed, we can infer some performance aspects:

Feature/TestAcceptance Criteria (Inferred)Reported Device Performance
Electrical SafetyCompliance with IEC 60601-1Testing in accordance with IEC 60601-1 (device passed)
Electromagnetic Compatibility (EMC)Compliance with IEC 60601-1-2Testing in accordance with IEC 60601-1-2 (device passed)
Special Requirements for Electrosurgical UnitsCompliance with IEC 60601-2-2Testing in accordance with IEC 60601-2-2 (device passed)
Endoscopic Equipment (Electrosurgical)Compliance with IEC 60601-2-18Testing in accordance with IEC 60601-2-18 (device passed)
AppearanceMeets specificationAll testing results show that the Endoscopic Surgical Instruments meet the specification and performance characteristics as identified in internal design control procedures.
Basic DimensionMeets specificationAll testing results show that the Endoscopic Surgical Instruments meet the specification and performance characteristics as identified in internal design control procedures.
Corrosion ResistanceMeets specificationAll testing results show that the Endoscopic Surgical Instruments meet the specification and performance characteristics as identified in internal design control procedures.
Transverse Holding ForceMeets specificationAll testing results show that the Endoscopic Surgical Instruments meet the specification and performance characteristics as identified in internal design control procedures.
Longitudinal Holding ForceMeets specificationAll testing results show that the Endoscopic Surgical Instruments meet the specification and performance characteristics as identified in internal design control procedures.
Ratchet Holding ForceMeets specificationAll testing results show that the Endoscopic Surgical Instruments meet the specification and performance characteristics as identified in internal design control procedures.
Cutting EfficacyMeets specificationAll testing results show that the Endoscopic Surgical Instruments meet the specification and performance characteristics as identified in internal design control procedures.
Thermal Effects on TissueAcceptable thermal damage zoneThe thermal effect has been performed on fresh pig's liver, kidney, and muscle tissue. The thermal damage zone is measured under magnification using histology after performing cauterizing. All testing results show the device meets internal specifications.
BiocompatibilityCompliance with ISO 10993 seriesThe device meets the applicable requirements of the FDA Blue Book Memorandum G95-11 entitled Use of International Standards ISO 10993-1:2009 Biological Evaluation of Medical Devices-Part 1: Evaluation and Testing within a risk management process, including ISO 10993-5, -7, -10, -11, -12.
Sterility (Reusable Instruments)Sterility Assurance Level (SAL) of 10⁻⁶Both EO and Steam sterilization methods have been validated, and test reports show that the sterilization effect of the proposed device can achieve a SAL of 10⁻⁶.

2. Sample Size Used for the Test Set and the Data Provenance

The document describes non-clinical laboratory testing (e.g., electrical safety, performance, biocompatibility). It does not involve a "test set" in the context of clinical data or AI model evaluation.

  • Sample Size for performance tests: Not explicitly stated for each test, but implied to be sufficient for demonstrating compliance with specified standards and characteristics. For the thermal effects on tissue, it involved "fresh pig's liver, kidney, and muscle tissue," but the number of samples is not quantified.
  • Data Provenance: The tests were conducted in a laboratory setting as part of the device's design control and regulatory submission. The document doesn't specify the country of origin for the non-clinical test data itself, beyond the manufacturer being based in China. The study is a prospective evaluation of the device against predefined performance standards and characteristics.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and the Qualifications of Those Experts

Not applicable. This device is an electrosurgical instrument for cutting, dissecting, manipulating, and cauterizing tissues. There is no AI component or image analysis that would require expert adjudication to establish "ground truth" for a test set. The evaluation is based on objective measurements and compliance with technical standards.

4. Adjudication Method for the Test Set

Not applicable, as there is no "test set" in the context of expert review or clinical data.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, If so, What Was the Effect Size of How Much Human Readers Improve with AI vs Without AI Assistance

Not applicable. This is a medical device (surgical instrument), not an AI-powered diagnostic or assistive tool for human readers.

6. If a Standalone (i.e. algorithm only without human-in-the-loop performance) Was Done

Not applicable. This device is a manual surgical instrument that requires human operation. It does not have an autonomous algorithm component.

7. The Type of Ground Truth Used

The "ground truth" in this context is the objective, measurable performance of the physical device against established engineering standards and specifications. Examples include:

  • Compliance with International Standards: IEC 60601-1, IEC 60601-1-2, IEC 60601-2-2, IEC 60601-2-18, ISO 10993 series.
  • Physical and Functional Specifications: Appearance, basic dimension, corrosion resistance, various holding forces (transverse, longitudinal, ratchet), cutting efficacy.
  • Biological Outcome: Thermal damage zone measured via histology on tissue samples, sterility assurance level (SAL).

8. The Sample Size for the Training Set

Not applicable. This is a physical medical device, not an AI model requiring a training set.

9. How the Ground Truth for the Training Set Was Established

Not applicable. As there is no AI model, there is no training set or associated ground truth establishment process.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

February 13, 2018

Hunan Handlike Minimally Invasive Surgery Co., Ltd % Ms. Elly Xu Shenzhen Joyantech Consulting Co., Ltd Room 1122, No.55 Shizhou Middle Road, Nanshan District Shenzhen, Guangdong, P.R.China

Re: K171825

Trade/Device Name: Endoscopic Surgical Instrument Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical cutting and coagulation device and accessories Regulatory Class: Class II Product Code: GEI Dated: December 10, 2017 Received: December 18, 2017

Dear Ms. Xu:

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-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820);

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and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely. Jennifer R. Stevenson -

53

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

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Indications for Use

510(k) Number (if known) K171825

Device Name Endoscopic Surgical Instrument

Indications for Use (Describe)

Endoscopic Instruments are designed to cut, dissect, manipulate and/or cauterize various tissues during endoscopic/ laparoscopic, general surgical procedures.

Type of Use (Select one or both, as applicable)X Prescription Use (Part 21 CFR 801 Subpart D)

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

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Product: Endoscopic Surgical Instruments

Version: A/0

VOL 005_510(k) Summary

This 510(K) Summary is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR §807.92.

1. Submission Sponsor

Applicant NameHunan Handlike Minimally Invasive Surgery Co.,Ltd
AddressA4, Lugu Yuyuan, #27, Wenxuan Rd, High-tech Zone,Changsha, Hunan, CHINA
Post Code410205
Phone No.86-731-89727782
Fax No.86-731-88830694
Contact PersonHanhan Hu
Emailhuhanhan@handlike.cn
Date Prepared2018-2-10

2. Submission correspondent

Image /page/3/Picture/10 description: The image shows a company logo with the text "Name" and "Address" above it. The logo is green and features a stylized animal head with wings. Below the logo, there are four Chinese characters, which translate to "Zhuo Yuan Tian Cheng."

Email

Shenzhen Joyantech Consulting Co., Ltd Room 1122, No.55 Shizhou Middle Road, Nanshan District, Shenzhen, Guangdong, P.R.China Post Code 518000 Phone No. 86-755-86069197 Contact Person Elly Xu; Field Fu

elly@cefda.com; cefda13485@163.com

3. Devices Identification

Trade nameEndoscopic Surgical Instrument
Common nameEndoscopic Surgical Instrument
ModelDisposable Endoscopic Surgical Instrument
Reusable Endoscopic Surgical Instrument
ClassificationII
Classification nameElectrosurgical, Cutting & Coagulation & Accessories
Regulation number878.4400
Product codeGEI
510(k) review panelGeneral & Plastic Surgery
Performance standardsThe performance and safety was evaluated in

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K171825

Hunan Handlike Minimally Invasive Surgery Co.,LtdVOL_005:001_510(K) Summary
Product: Endoscopic Surgical InstrumentsVersion: A/0
accordance with Electrosurgical Device Guidanceof FDA.
Biocompatibility tests were done in conformancewith relevant requirements of ISO10993.

4. Leqally Marketed Predicate Devices

Trade NameEndoscopic Surgical Instruments
Regulation number878.4400
Regulation classII
Regulation nameElectrosurgical, Cutting & Coagulation & Accessories
510(k) NumberK132771
Product CodeGEI
ManufacturerQingdao Kingston Medical Devices Ltd.
Trade NameEndoscopic Surgical Instruments
Regulation number878.4400
Regulation classII
Regulation nameElectrosurgical, Cutting & Coagulation & Accessories
510(k) NumberK102921
Product CodeGEI
ManufacturerBEMA GmbH & Co. KG

5. Device Description

Endoscopic Surgical Instrument is a kind of device used to cut, dissect, manipulate and/or cauterize various tissues during endoscopic/laparoscopic, general surgical procedures. The device includes Disposable Endoscopic Surgical Instrument and Reusable Endoscopic Surgical Instrument. Both of the disposable and reusable endoscopic instruments are provided sterile when they're released. After used for the first time, Reusable Endoscopic Instrument needs to be sterilized by the end users. The instruments are 5mm in diameter as well as 340mm in length.

6. Indications for Use Statement

Endoscopic Instruments are designed to cut, dissect, manipulate and/or cauterize various tissues during endoscopic/laparoscopic, general surgical procedures.

7. Substantial Equivalence Discussion

7.1 Comparison between Disposable Endoscopic Surgical Instrument and K132771

CharacteristicDisposable EndoscopicSurgical InstrumentEndoscopic SurgicalInstrumentComments
Indication forDisposable EndoscopicThe Endoscopic SurgicalSame

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Hunan Handlike Minimally Invasive Surgery Co.,Ltd

Product: Endoscopic Surgical Instruments

VOL_005:001_510(K) Summary Version: A/0

use/Intended useSurgical is designed to cut, dissect, manipulate and/or cauterize various tissues during endoscopic/laparoscopic, general surgical procedures.Instruments are intended for cutting, grasping, dissecting and coagulation of soft tissue in endoscopic surgical procedures. They are intended for single patient use.Same
Operation modeDevices are either monopolar endoscopic instruments for tissue manipulation and cutting/coagulation, or non-powered endoscopic instruments for tissue manipulation dissection, and cutting.Devices are either monopolar endoscopic instruments for tissue manipulation and cutting/coagulation, or non-powered endoscopic instruments for tissue manipulation dissection, and cutting.
StructureHandle, shaft and dissector/grasper/scissor jawHandle, shaft and dissector/grasper/scissor jaw
Diameter5mm/34cm5mm/33cm (or 42cm)Similar
SterilizationEOEOSame
Single UseYesYesSame
BiocompatibilityComply withISO 10993-5ISO 10993-7ISO 10993-10ISO 10993-11ISO 10993-12Comply withISO 10993-5ISO 10993-7ISO 10993-10ISO 10993-11ISO 10993-12Same
Electric Safety, EMC andPerformance TestIEC 60601-1,IEC 60601-1-2IEC 60601-2-2IEC 60601-2-18IEC 60601-1,IEC 60601-1-2IEC 60601-2-2Same

7.2 Comparison between Reusable Endoscopic Surgical Instrument and K102921

CharacteristicReusable EndoscopicSurgical InstrumentEndoscopic MonopolarInstruments andAccessoriesComments
Indication for use/Intended useReusable EndoscopicSurgical is designed to cut,dissect, manipulate and/orEndoscopic MonopolarInstruments andAccessories are used inSame
cauterize various tissueslaparoscopic and other
duringminimally invasive
endoscopic/laparoscopic,procedures for cutting,
general surgicaldissection, fixation and
procedures.taking of biopsy samples,
depending on the design
of the tip. They are also
intended to control
bleeding by use of
monopolar high-frequency
electrical current.
Devices are eitherDevices are either
monopolar endoscopicmonopolar endoscopic
instruments for tissueinstruments for tissue
manipulation andmanipulation and
Operation modecutting/coagulation, orcutting/coagulation, orSame
non-powered endoscopicnon-powered endoscopic
instruments for tissueinstruments for tissue
manipulation dissection,manipulation dissection,
and cutting.and cutting.
Handle, shaft and
Structuredissector/grasper/scissorHandle, shaft and tipSame
jaw
Assembly type,Two and Three-pieceSimilar, see
DesignTip-detachable typemodular system,Note 1
Single-piece instrument
Diameter5mm/34cmUnknownSee Note 2
SterilizationEO and SteamSteamSee Note 3
Comply withComply with
BiocompatibilityISO 10993-5ISO 10993-5
ISO 10993-7ISO 10993-7Same
ISO 10993-10ISO 10993-10
ISO 10993-11ISO 10993-11
ISO 10993-12ISO 10993-12
IEC 60601-1IEC 60601-1
Electric Safety,EMC andIEC 60601-1-2Same
IEC 60601-2-2IEC 60601-1-2
Performance TestIEC 60601-2-18IEC 60601-2-2

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Hunan Handlike Minimally Invasive Surgery Co.,Ltd

Product: Endoscopic Surgical Instruments

VOL_005:001_510(K) Summary Version: A/0

Note 1: The Assembly type and Tip-detachable type is similar with Two-piece modular system. Both the subject device and the predicate device can be detached into two pieces.

Note 2: The diameter of Reusable Endoscopic Surgical Instrument is similar to Page 4 of 5

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Hunan Handlike Minimally Invasive Surgery Co.,LtdVOL_005:001_510(K) Summary
Product: Endoscopic Surgical InstrumentsVersion: A/0

Endoscopic Surgical Instrument (K132711).

Note 3: The reusable endoscopic instruments are provided sterile when they're released from the manufacture. After used for the first time, Reusable Endoscopic Instrument needs to be steam sterilized by the end users. Both the steam sterilization have been validated, and the test reports show that the sterilization effect of the proposed device can achieve a Sterility Assurance Level (SAL) of 10°.

8. Non-clinical Testing

Evidence of safety and effectiveness was obtained from electrical safety testing and performance testing as following:

Testing in accordance with IEC 60601-1

Testing in accordance with IEC 60601-1-2

Testing in accordance with IEC 60601-2-2

Testing in accordance with IEC 60601-2-18

Moreover, other performance testing of Endoscopic Surgical Instruments were conducted included appearance, basic dimension, corrosion resistance, transverse holding force, longitudinal holding force, ratchet holding force, cutting efficacy and thermal effects on tissue. The thermal effect have been performed on the fresh pig's liver, kidney and muscle tissue. And the thermal damage zone is measured under magnification using histology after performing cauterizing. All the testing results show that the Endoscopic Surgical Instruments meet the specification and performance characteristics as identified in internal design control procedures.

Biocompatibility testing of the Endoscopic Surgical Instrument confirmed that the device meets the applicable requirements of the FDA Blue Book Memorandum G95-11 entitled Use of International Standards ISO 10993-1:2009 Biological Evaluation of Medical Devices-Part 1: Evaluation and Testing within a risk management process. All testings above were conducted per Electrosurgical Device Guidance of FDA.

9. Clinical Testing

Substantial equivalence does not depend on clinical test data.

10. Conclusions

Based on device comparison information and non-clinical testing, the differences between Endoscopic Surgical Instrument and predicate devices will be not raise any new issues of safety and effectiveness, Endoscopic Surgical Instrument is substantially equivalent to legally marketed predicate devices.

§ 878.4400 Electrosurgical cutting and coagulation device and accessories.

(a)
Identification. An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current.(b)
Classification. Class II.