K Number
K173019
Device Name
GYNECARE TVT Reusable Introducer, GYNECARE TVT Reusable Rigid Catheter Guide, GYNECARE TVT EXACT Continence System Trocar
Manufacturer
Date Cleared
2018-07-06

(281 days)

Product Code
Regulation Number
884.4910
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The GYNECARE TVT™ Reusable Introducer is a reusable device intended to aid in the placement of the GYNECARE TVT Device retropubically. The GYNECARE TVT™ Reusable Rigid Catheter Guide is a reusable device intended to facilitation of the urethra and bladder neck during the placement of the GYNECARE TVT Device and GYNECARE TVT EXACT Continence System. The GYNECARE TVT EXACT™ Continence System Trocar is a single use device intended to aid in the placement of the GYNECARE TVT EXACT Continence System retropubically.
Device Description
The subject devices include the following components: GYNECARE TVT™ Reusable Introducer GYNECARE TVTTM Reusable Rigid Catheter Guide GYNECARE TVT EXACT™ Continence System Trocar The subject devices are intended to be used with the GYNECARE TVT™ Device and GYNECARE TVT EXACT™ Continence System intended to treat stress urinary incontinence. GYNECARE TVT™ Reusable Introducer The GYNECARE TVT™ Introducer is provided non-sterile and is reusable. The Introducer is made of stainless steel. It consists of two parts, a handle and an inserted threaded metal shaft. The Introducer is intended to facilitate the passage of the GYNECARE TVT™ Device from the vagina to the abdominal skin. It is connected and fixed to the threaded end of the shaft, prior to inserting the needle with the tape. GYNECARE TVT™ Reusable Rigid Catheter Guide The GYNECARE TVT™ Rigid Catheter Guide is a non-sterile reusable instrument intended to facilitate the identification of the urethra and the bladder neck during the surgical procedure. It is inserted into a Folev catheter (recommended size 18 French) positioned in the urethra. To facilitate insertion, it can be lubricated with gel. GYNECARE TVT EXACT™ Continence System Trocar The GYNECARE TVT EXACT™ Continence System Trocar consists of the stainless steel Trocar Shaft and the plastic Trocar Handle. The Trocar Shaft is designed to fit inside the white Trocar Sheaths on the GYNECARE TVT EXACT™ Continence System Implant / Trocar Sheath Assembly, and is used to position the GYNECARE TVT EXACT™ Continence System Implant in the patient from a vaginal incision up through the abdominal wall.
More Information

No
The device description and performance studies focus on mechanical and material properties of reusable and single-use surgical instruments, with no mention of software, algorithms, or data processing.

No
The devices aid in the placement of other medical devices (GYNECARE TVT Device and GYNECARE TVT EXACT Continence System) which are intended to treat stress urinary incontinence, but they themselves are introducers, guides, and trocars, not directly providing therapy.

No

The devices described are surgical instruments used to aid in the placement of other medical devices for treating stress urinary incontinence. Their stated purpose is to facilitate passage, identification, or positioning, not to diagnose a condition or disease.

No

The device description explicitly details physical, reusable and single-use hardware components made of stainless steel and plastic, intended for surgical procedures. There is no mention of software.

Based on the provided text, these devices are not In Vitro Diagnostic (IVD) devices.

Here's why:

  • Intended Use: The intended use of these devices is to aid in the surgical placement of implants for treating stress urinary incontinence. This is a surgical procedure performed in vivo (within the body), not a test performed in vitro (outside the body) on biological samples to diagnose a condition.
  • Device Description: The descriptions detail surgical instruments (introducers, catheter guides, trocars) used to manipulate tissues and guide implants during surgery. They do not describe reagents, calibrators, control materials, or other components typically associated with IVD tests.
  • Performance Studies: The performance studies listed focus on aspects relevant to surgical devices, such as sterilization, reprocessing, mechanical performance, biocompatibility, and shelf life. They do not include studies related to analytical or clinical performance metrics typical of IVD devices (e.g., sensitivity, specificity, accuracy in detecting analytes).

In summary, these devices are surgical instruments used in a procedure, not devices used to perform diagnostic tests on biological samples.

N/A

Intended Use / Indications for Use

The GYNECARE TVT™ Reusable Introducer is a reusable device intended to aid in the placement of the GYNECARE TVT Device retropubically.

The GYNECARE TVT™ Reusable Rigid Catheter Guide is a reusable device intended to facilitation of the urethra and bladder neck during the placement of the GYNECARE TVT Device and GYNECARE TVT EXACT Continence System.

The GYNECARE TVT EXACT™ Continence System Trocar is a single use device intended to aid in the placement of the GYNECARE TVT EXACT Continence System retropubically.

Product codes

PWJ

Device Description

The subject devices include the following components:
GYNECARE TVT™ Reusable Introducer
GYNECARE TVTTM Reusable Rigid Catheter Guide
GYNECARE TVT EXACT™ Continence System Trocar

The subject devices are intended to be used with the GYNECARE TVT™ Device and GYNECARE TVT EXACT™ Continence System intended to treat stress urinary incontinence.

The GYNECARE TVT™ Introducer is provided non-sterile and is reusable. The Introducer is made of stainless steel. It consists of two parts, a handle and an inserted threaded metal shaft. The Introducer is intended to facilitate the passage of the GYNECARE TVT™ Device from the vagina to the abdominal skin. It is connected and fixed to the threaded end of the shaft, prior to inserting the needle with the tape.

The GYNECARE TVT™ Rigid Catheter Guide is a non-sterile reusable instrument intended to facilitate the identification of the urethra and the bladder neck during the surgical procedure. It is inserted into a Folev catheter (recommended size 18 French) positioned in the urethra. To facilitate insertion, it can be lubricated with gel.

The GYNECARE TVT EXACT™ Continence System Trocar consists of the stainless steel Trocar Shaft and the plastic Trocar Handle. The Trocar Shaft is designed to fit inside the white Trocar Sheaths on the GYNECARE TVT EXACT™ Continence System Implant / Trocar Sheath Assembly, and is used to position the GYNECARE TVT EXACT™ Continence System Implant in the patient from a vaginal incision up through the abdominal wall.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

urethra, bladder neck, vagina, abdominal wall

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 following performance tests were completed on the subject devices:

  • Sterilization validation
  • Reprocessing validation
  • Package integrity
  • Dimensional and mechanical performance
  • Biocompatibility
    • o Cytotoxicity
    • o Sensitization
    • o Irritation
  • . Shelf life

The results of performance testing demonstrate the subject devices are sterile to an SAL for 106. biocompatible, have sufficient mechanical performance for their intended use, have a validated shelf life, and that the GYNECARE TVT Introducer and GYNECARE TVT Rigid Catheter Guide reusable devices can be adequately reprocessed.

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

Not Found

Predicate Device(s)

K974098

Reference Device(s)

K132054

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 884.4910 Specialized surgical instrumentation for use with urogynecologic surgical mesh.

(a)
Identification. Specialized surgical instrumentation for use with urogynecologic surgical mesh is a prescription device specifically intended for use as an aid in the insertion, placement, fixation, or anchoring of surgical mesh during urogynecologic procedures. These procedures include transvaginal pelvic organ prolapse repair, sacrocolpopexy (transabdominal pelvic organ prolapse repair), and treatment of female stress urinary incontinence. Examples of specialized surgical instrumentation include needle passers and trocars, needle guides, fixation tools, and tissue anchors. This device is not a manual gastroenterology-urology surgical instrument and accessories (§ 876.4730) or a manual surgical instrument for general use (§ 878.4800).(b)
Classification. Class II (special controls). The special controls for specialized surgical instrumentation for use with urogynecologic surgical mesh are:(1) The device must be demonstrated to be biocompatible;
(2) The device must be demonstrated to be sterile and, if reusable, it must be demonstrated that the device can be adequately reprocessed;
(3) Performance data must support the shelf life of the device by demonstrating package integrity and device functionality over the requested shelf life;
(4) Non-clinical performance testing must demonstrate that the device meets all design specifications and performance requirements, and that the device performs as intended under anticipated conditions of use; and
(5) Labeling must include:
(i) Information regarding the mesh design that may be used with the device;
(ii) Detailed summary of the clinical evaluations pertinent to use of the device;
(iii) Expiration date; and
(iv) Where components are intended to be sterilized by the user prior to initial use and/or are reusable, validated methods and instructions for sterilization and/or reprocessing of any reusable components.

0

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.

July 6, 2018

Ethicon Inc. Melina Escobar Regulatory Affairs Specialist Ethicon Women's Health and Urology P.O. Box 151 Route 22 West Somerville, New Jersey 08876-0151

Re: K173019

Trade/Device Name: GYNECARE TVT™ Reusable Introducer, GYNECARE TVTTM Reusable Rigid Catheter Guide, GYNECARE TVT EXACT™ Continence System Trocar Regulation Number: 21 CFR 884.4910 Regulation Name: Specialized surgical instrumentation for use with urogynecologic surgical mesh Regulatory Class: Class II Product Code: PWJ Dated: May 24, 2018 Received: June 6, 2018

Dear Melina Escobar:

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

1

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 (OS) regulation (21 CFR Part 820); 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 comprehensive regulatory information about mediation-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,

Michael T. Bailey -S

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

Enclosure

2

Indications for Use

510(k) Number (if known) K173019

Device Name GYNECARE TVT™ Reusable Introducer GYNECARE TVT™ Reusable Rigid Catheter Guide GYNECARE TVT EXACT™ Continence System Trocar

Indications for Use (Describe)

The GYNECARE TVT™ Reusable Introducer is a reusable device intended to aid in the placement of the GYNECARE TVT Device retropubically.

The GYNECARE TVT™ Reusable Rigid Catheter Guide is a reusable device intended to facilitation of the urethra and bladder neck during the placement of the GYNECARE TVT Device and GYNECARE TVT EXACT Continence System.

The GYNECARE TVT EXACT™ Continence System Trocar is a single use device intended to aid in the placement of the GYNECARE TVT EXACT Continence System retropubically.

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)

CONTINUE ON A SEPARATE PAGE IF NEEDED.

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."

3

Image /page/3/Picture/0 description: The image shows the logo for Ethicon, a Johnson & Johnson company. The word "ETHICON" is written in large, red, sans-serif letters. Below the company name, in a smaller, cursive font, is the text "a Johnson & Johnson company."

510(k) Summary – K173019

| Submitter: | Ethicon Women's Health and Urology
A Division of Ethicon, Inc. a Johnson & Johnson company
P.O. Box 151
Route 22 West
Somerville, NJ 08876-0151 |
|---------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact Person: | Melina Escobar
Regulatory Affairs Specialist
Ph: (908) 218-2583
Fax: (908) 218-2595
Email: mescob14@its.jnj.com |
| Date Prepared: | July 5, 2018 |
| Device Trade Names: | GYNECARE TVT™ Reusable Introducer
GYNECARE TVT™ Reusable Rigid Catheter Guide
GYNECARE TVT EXACT™ Continence System Trocar |
| Common Name: | Specialized urogynecologic surgical mesh instrumentation |
| Regulation Name: | Specialized surgical instrumentation for use with urogynecologic
surgical mesh |
| Regulation Number: | 21 CFR 884.4910 |
| Regulatory Class: | II |
| Product Code: | PWJ (instrumentation, surgical mesh, urogynecologic, stress
urinary incontinence) |
| Predicate Device: | GYNECARE TVT™ Tension Free Vaginal Tape (TVT System)
Ethicon, Inc., 510(k) K974098
GYNECARE TVT EXACT™ Continence System, Ethicon, Inc. |

4

The predicate devices have not been subject to a design related recall.

Device Description

The subject devices include the following components:

GYNECARE TVT™ Reusable Introducer GYNECARE TVTTM Reusable Rigid Catheter Guide GYNECARE TVT EXACT™ Continence System Trocar

The subject devices are intended to be used with the GYNECARE TVT™ Device and GYNECARE TVT EXACT™ Continence System intended to treat stress urinary incontinence.

GYNECARE TVT™ Reusable Introducer

The GYNECARE TVT™ Introducer is provided non-sterile and is reusable. The Introducer is made of stainless steel. It consists of two parts, a handle and an inserted threaded metal shaft. The Introducer is intended to facilitate the passage of the GYNECARE TVT™ Device from the vagina to the abdominal skin. It is connected and fixed to the threaded end of the shaft, prior to inserting the needle with the tape.

GYNECARE TVT™ Reusable Rigid Catheter Guide

The GYNECARE TVT™ Rigid Catheter Guide is a non-sterile reusable instrument intended to facilitate the identification of the urethra and the bladder neck during the surgical procedure. It is inserted into a Folev catheter (recommended size 18 French) positioned in the urethra. To facilitate insertion, it can be lubricated with gel.

GYNECARE TVT EXACT™ Continence System Trocar

The GYNECARE TVT EXACT™ Continence System Trocar consists of the stainless steel Trocar Shaft and the plastic Trocar Handle. The Trocar Shaft is designed to fit inside the white Trocar Sheaths on the GYNECARE TVT EXACT™ Continence System Implant / Trocar Sheath Assembly, and is used to position the GYNECARE TVT EXACT™ Continence System Implant in the patient from a vaginal incision up through the abdominal wall.

Indications for Use

The GYNECARE TVT™ Reusable Introducer is a reusable device intended to aid in the placement of the GYNECARE TVT Device retropubically.

The GYNECARE TVT™ Reusable Rigid Catheter Guide is a reusable device intended to facilitate the identification of the urethra and bladder neck during the placement of the GYNECARE TVT Device and GYNECARE TVT EXACT Continence System.

5

The GYNECARE TVT EXACT™ Continence System Trocar is a single use device intended to aid in the placement of the GYNECARE TVT EXACT Continence System retropubically.

Summary of Substantial Equivalence Comparison

| Device and

Predicate DevicesK173019K974098K132054
Indications for Use
StatementThe GYNECARE
TVTTM Reusable
Introducer is a
reusable device
intended to aid in the
placement of the
GYNECARE TVT
Device
retropubically.
The GYNECARE
TVTTM Reusable
Rigid Catheter Guide
is a reusable device
intended to facilitate
the identification of
the urethra and
bladder neck during
the placement of the
GYNECARE TVT
Device and
GYNECARE TVT
EXACT Continence
System.
The GYNECARE
TVT EXACTTM
Continence System
Trocar is a single use
device intended to aid
in the placement of
the GYNECARE
TVT EXACT
Continence System
retropubically.The TVT device is a
sterile, single-use
device intended to be
used as a
pubourethral sling
indicated for
treatment of stress
urinary incontinence
(SUI), for female
urinary incontinence
resulting from
urethral
hypermobility and/or
intrinsic sphincter
deficiency. The TVT
Introducer and Rigid
Catheter Guide
accessories are
intended to facilitate
placement of the
TVT device. The
accessories, available
separately, are
provided non-sterile
and are reusable.The GYNECARE
TVT EXACTTM
Continence System is
intended to be used as
a pubourethral sling
for treatment of
female stress urinary
incontinence,
resulting from
urethral
hypermobility and/or
intrinsic sphincter
deficiency.
Operating principleAid in the placement
of surgical meshTreatment of women
with stress urinary
incontinenceTreatment of women
with stress urinary
incontinence

The following table compares the subject and predicate device.

6

| Patient contact
durations |