K Number
K180208
Device Name
Disposable Endoscopic Trocar
Date Cleared
2018-04-09

(75 days)

Product Code
Regulation Number
876.1500
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Disposable Endoscopic Trocar has applications in abdominal, thoracic, and gynecologic minimally invasive surgical procedures to establish a path of entry for endoscopic instruments. The trocar may be used with or without visualization for primary and secondary insertions.
Device Description
The Fengh Medical Disposable Endoscopic Trocar has applications in abdominal, thoracic and gynecologic minimally invasive surgical procedures to establish a path of entry for endoscopic instruments. The trocar may be used with or without visualization for primary and secondary insertions. A Disposable Endoscopic Trocar is mainly composed of Obturator Handle, Outer Seal Release Lever. Trocar Stability Sleeve, Obturator Locking Button, Trocar Stability Sleeve, etc. Materials being used include Stainless 12Cr18Ni9, Stainless 06Cr19Ni10, ABS plastic, PC. All the components of Disposable Endoscopic Trocar are evaluated by cytotoxicity test, sensitization test, intracutaneous mucosa stimulation test, Systemic toxicity(acute) test and Pyrogenicity test. Therefore, it will not cause bad stimulations, allergic reactions or other harm to human tissue or mucosa. Furthermore, no toxic substances will be separated out during the use of Disposable Endoscopic Trocar. Endoscopic surgery is conducted through a cannula that extends across the abdominal wall and provides channels where instruments, such as scopes, retractors and staplers, can be inserted to perform surgery. As part of this procedure, the abdominal cavity is inflated with an insufflation gas, such carbon dioxide, to maintain the abdomen in a distended state and provide increased instrument maneuvering capability within the cavity. Valves are typically provided in the trocars to form seals around the instruments to prevent leakage of the insufflation gas.
More Information

Not Found

No
The description details a mechanical device for surgical access and does not mention any software, algorithms, or data processing capabilities indicative of AI/ML.

No.
The device is a surgical instrument used to establish a path for other endoscopic instruments, not to treat a medical condition itself.

No
Explanation: The device, a Disposable Endoscopic Trocar, is used to establish an entry path for surgical instruments during minimally invasive procedures. Its function is to facilitate surgery, not to identify or monitor medical conditions.

No

The device description explicitly lists physical components made of materials like stainless steel and plastic, and the performance studies include tests for physical properties like peel strength, flexibility, and leakage, indicating it is a hardware device.

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

Here's why:

  • Intended Use: The intended use is to "establish a path of entry for endoscopic instruments" in surgical procedures. This is a surgical tool used during a procedure on the body, not a device used to examine specimens outside the body to diagnose a condition.
  • Device Description: The description details the physical components and function of a surgical trocar, which is used to create access for instruments. It does not mention any components or processes related to analyzing biological samples.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Detecting or measuring specific analytes
    • Providing diagnostic information about a patient's health status
    • Reagents or assays

The testing performed (sterility, peel strength, biocompatibility, etc.) is consistent with a surgical device, not an IVD.

N/A

Intended Use / Indications for Use

The Disposable Endoscopic Trocar has applications in abdominal, thoracic, and gynecologic minimally invasive surgical procedures to establish a path of entry for endoscopic instruments. The trocar may be used with or without visualization for primary and secondary insertions.

Product codes

GCJ

Device Description

The Fengh Medical Disposable Endoscopic Trocar has applications in abdominal, thoracic and gynecologic minimally invasive surgical procedures to establish a path of entry for endoscopic instruments. The trocar may be used with or without visualization for primary and secondary insertions.

A Disposable Endoscopic Trocar is mainly composed of Obturator Handle, Outer Seal Release Lever. Trocar Stability Sleeve, Obturator Locking Button, Trocar Stability Sleeve, etc. Materials being used include Stainless 12Cr18Ni9, Stainless 06Cr19Ni10, ABS plastic, PC. All the components of Disposable Endoscopic Trocar are evaluated by cytotoxicity test, sensitization test, intracutaneous mucosa stimulation test, Systemic toxicity(acute) test and Pyrogenicity test. Therefore, it will not cause bad stimulations, allergic reactions or other harm to human tissue or mucosa. Furthermore, no toxic substances will be separated out during the use of Disposable Endoscopic Trocar.

Endoscopic surgery is conducted through a cannula that extends across the abdominal wall and provides channels where instruments, such as scopes, retractors and staplers, can be inserted to perform surgery. As part of this procedure, the abdominal cavity is inflated with an insufflation gas, such carbon dioxide, to maintain the abdomen in a distended state and provide increased instrument maneuvering capability within the cavity. Valves are typically provided in the trocars to form seals around the instruments to prevent leakage of the insufflation gas.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

abdominal, thoracic, and gynecologic

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)

Table 1Tests
ClinicalNot Applicable
Non-Clinical Testing:Sterility Test
Peel Strength
Flexibility
Fitness
Leakage
Roughness
Dimension
Appearance
Insertion & Cannula Stability
Trocar sleeve retention force
Endoscope Visualization Quality
Biocompatibility Testing:In Vitro Cytotoxicity Test
Skin Sensitization Test
Intracutaneous reactivity Test
Acute Systemic Toxicity
Pyrogen Test

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

Not Found

Predicate Device(s)

K032676

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 876.1500 Endoscope and accessories.

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

0

Image /page/0/Picture/0 description: The image shows the logos of the Department of Health and Human Services (HHS) and the Food and Drug Administration (FDA). The HHS logo is on the left, and the FDA logo is on the right. The FDA logo includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

April 9, 2018

Fengh Medical Co., Ltd. Jun Zhou Regulatory Affairs Manager D3 No. 6 Dongsheng West Road, Jiangyin National High-tech Zone Jiangyin, 214437 Cn

Re: K180208

Trade/Device Name: Disposable Endoscopic Trocar Regulation Number: 21 CFR 876.1500 Regulation Name: Endoscope And Accessories Regulatory Class: Class II Product Code: GCJ Dated: February 8, 2018 Received: February 12, 2018

Dear Jun Zhou:

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, 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);

1

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 -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

510(k) Number (if known) K180208

Device Name Disposable Endoscopic Trocar

Indications for Use (Describe)

The Disposable Endoscopic Trocar has applications in abdominal, thoracic, and gynecologic minimally invasive surgical procedures to establish a path of entry for endoscopic instruments. The trocar may be used with or without visualization for primary and secondary insertions.

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/1 description: The image shows a logo for FENG Medical. The logo is in blue and teal. The word "FENG" is in blue, and the word "Medical" is in a smaller font below the "G" in FENG.

Fengh Medical Co., Ltd. 510(k) Submission Trocar

510 (k) SUMMARY OF SAFETY AND EFFECTIVENESS

(As Required by 21 CFR 807.92)

1. Date Prepared [21 CFR 807.92(a)(1)]

02/20/2018

2. Submitter's Information [21 CFR 807.92(a)(1)]

Company Name:Fengh Medical Co., Ltd.
Company Address:D3 No.6 Dongsheng West Road, Jiangyin National High
tech Zone, 214437 Jiangsu, China
Contact Person:Jun Zhou
Phone:86 - 15906171661
Email:zj_fenghmedical@163.com

3. Trade Name, Common Name, Classification [21 CFR 807.92(a)(2)]

Trade Name:Disposable Endoscopic Trocar
Common Name:General & Plastic Surgery
Product Code:GCJ
Regulation Number:21 CFR 876.1500
Device Class:II

4. Identification of Predicate Devices(s) [21 CFR 807.92(a)(3)[

The identification of predicates within this submission is as follow:

Predicate I
Manufacturer:Ethicon Endo-Surgery, Inc
Trade Name:ENDOPATH III Bladeless Trocars
ENDOPATH III Blunt Tip Trocars
ENDOPATH III Dilating Tip Trocars
Common Name:ENDOPATH III Trocar System
Product Code:GCJ
Classification Name:General& Plastic Surgery
Regulation Number:21 CFR 876.1500
Classification:Class II
FDA 510 (k) Number:K032676

SECTION 6 - 2 of 7

4

Image /page/4/Picture/0 description: The image shows the text 'K180208 p 3/7'. This appears to be an identifier or code, possibly a document or page number. The 'p' likely stands for 'page', indicating that this is page 3 of a 7-page document. The 'K180208' could be a unique identifier for the document itself.

Image /page/4/Picture/1 description: The image shows a logo for FENG Medical. The logo consists of the word "FENG" in blue, with a stylized "h" in a circle to the right. To the left of "FENG" are two Chinese characters in a similar blue color. Below the "h" is the word "Medical" in a smaller font.

Fengh Medical Co., Ltd. 510(k) Submission Trocar

5. Description of the Device [21 CFR 807.92(a)(4)]

The Fengh Medical Disposable Endoscopic Trocar has applications in abdominal, thoracic and gynecologic minimally invasive surgical procedures to establish a path of entry for endoscopic instruments. The trocar may be used with or without visualization for primary and econdary insertions.

A Disposable Endoscopic Trocar is mainly composed of Obturator Handle, Outer Seal Release Lever. Trocar Stability Sleeve, Obturator Locking Button, Trocar Stability Sleeve, etc. Materials being used include Stainless 12Cr18Ni9, Stainless 06Cr19Ni10, ABS plastic, PC. All the components of Disposable Endoscopic Trocar are evaluated by cytotoxicity test, sensitization test, intracutaneous mucosa stimulation test, Systemic toxicity(acute) test and Pyrogenicity test. Therefore, it will not cause bad stimulations, allergic reactions or other harm to human tissue or mucosa. Furthermore, no toxic substances will be separated out during the use of Disposable Endoscopic Trocar.

Endoscopic surgery is conducted through a cannula that extends across the abdominal wall and provides channels where instruments, such as scopes, retractors and staplers, can be inserted to perform surgery. As part of this procedure, the abdominal cavity is inflated with an insufflation gas, such carbon dioxide, to maintain the abdomen in a distended state and provide increased instrument maneuvering capability within the cavity. Valves are typically provided in the trocars to form seals around the instruments to prevent leakage of the insufflation gas.

6. Intended Use [21 CFR 807.92(a)(5)]

The Disposable Endoscopic Trocar has applications in abdominal, thoracic, and gynecologic minimally invasive surgical procedures to establish a path of entry for endoscopic instruments. The trocar may be used with or without visualization for primary and secondary insertions.

7. Technological Characteristic [21 CFR 807.92(a)(6)]

Optical Entry

  • Visualization is optically guided by a 0° endoscope .
  • . Enables visualization of tissue layers during insertion Durable Universal Seal

SECTION 6 - 3 of 7

5

风和FE

Fengh Medical Co., Ltd. 510(k) Submission Trocar

  • . No reducer caps needed
  • Maintains insufflation ●

Camera Scope-Locking Tab

  • Holds camera locked in place during visually guided entry ●
  • Helps provide visual clarity and protects camera from scratching or falling out . Integrated Stability Thread Design
  • Maximizes abdominal wall retention for minimal trocar slip-outs ●

Bladeless Optical Tip

  • Separates, rather than cuts, along tissue fibers ●
  • . Reduced risk of abdominal wall injuries

8. Testing

Table 1Tests
ClinicalNot Applicable
Non-Clinical Testing:Sterility Test
Peel Strength
Flexibility
Fitness
Leakage
Roughness
Dimension
Appearance
Insertion & Cannula Stability
Trocar sleeve retention force
Endoscope Visualization Quality
Biocompatibility Testing:In Vitro Cytotoxicity Test
Skin Sensitization Test
Intracutaneous reactivity Test
Acute Systemic Toxicity
Pyrogen Test

9. Substantial Equivalence [21 CFR 807.92(b)(1) and 807.92(b)(2)]

Table 2Proposed DevicePredicate Device
Device NameDisposable Endoscopic TrocarENDOPATH@ III Bladeless
Trocars
Trade NameDisposable Endoscopic TrocarENDOPATH@ III Bladeless
Trocars
ENDOPATH@ III Blunt Tip
Trocars
ENDOPATH@ III Dilating
Tip Trocars
Device
ClassificationIIII
Regulation
Number21 CFR 876.150021 CFR 876.1500
Product CodeGCJGCJ
Intended UseThe Disposable Endoscopic
Trocar has applications in
abdominal, thoracic, and
gynecologic minimally invasive
surgical procedures to establish
a path of entry for endoscopic
instruments. The trocar may be
used with or without
visualization for primary and
secondary insertions.The ENDOPATH III Bladeless
Trocar has applications in
abdominal, thoracic, and
gynecologic minimally
invasive procedures to
establish a path of entry for
endoscopic instruments. The
trocar may be used with or
without visualization for
primary and secondary
insertions.
The ENDOPATH III Dilating
Tip Trocar has applications in
thoracic, gynecologic
laparoscopy and other
abdominal procedures to
establish a path of entry for
endoscopic instruments.
The ENDOPATH III Blunt Tip
Trocar has applications in
thoracic, gynecologic,
laparoscopic and other
abdominal procedures to
establish a path of entry for
minimally invasive
instruments.
Sizes (Diameter)5mm5mm
N/A8mm
10mmN/A
N/A11mm
12mm12mm
N/A15mm
Size (Length)N/A75mm
100mm100mm
N/A150mm
Principles of
During the operation, the trocarDuring the operation, the
operationsleeve and the obturator are
used together. The surgeon uses
the obturator to expand the
incision of the abdomen and
penetrates the trocar sleeve
through the abdominal surface
of the human body into the
abdominal cavity, thereby
delivering gas to the abdominal
cavity and establishing a path of
entry for endoscopic
instruments.trocar sleeve and the obturator
are used together. The surgeon
uses the obturator to expand
the incision of the abdomen
and penetrates the trocar sleeve
through the abdominal surface
of the human body into the
abdominal cavity, thereby
delivering gas to the abdominal
cavity and establishing a path
of entry for endoscopic
instruments.
Main
ComponentsObturator
Obturator Handle
Scope locking Cam (Except
FLPC5, FLPC10, FLPC12)
Obturator Locking Button
(housed in obturator handle)
Outer Seal
Outer Seal Release Lever
(Except FLPC5,FLPC10,
FLPC12)
Stopcock
Trocar Smooth Sleeve
Trocar Stability Sleeve
Optical Element
Bladeless Tip
N/A
N/AObturator
Obturator Handle
Scope locking Cam (housed in
obturator handle)
Obturator Locking Button
(housed in obturator handle)
Outer Seal
Outer Seal Release Lever
Stopcock
Trocar Smooth Sleeve
Trocar Stability Sleeve
Optical Element
Bladeless Tip
Bladeless Tip Symbol
Pistol Handle
Patient
Contacting
StructureObturator
Trocar Smooth Sleeve
Trocar Stability Sleeve
Optical Element
Bladeless TipObturator
Trocar Smooth Sleeve
Trocar Stability Sleeve
Optical Element
Bladeless Tip
Patient
Contacting
MaterialABS-1, MN, 095-30-16-
15/PC/Stainless 12Cr18Ni9
(Except FLPC5, FLPC10,
FLPC12)/Stainless 06Cr19Ni10
(Except FLPC5, FLPC10,
FLPC12)N/A
SterilizationSterilized using IrradiationN/A
Application
SitesAbdominal
ThoracicAbdominal
Thoracic
Number of Ports11
Single UseYesYes
Obturator &
Cannula
CompatibilitySleeve and Obturator should fit
well without any interference.
Max clearance between sleeve
and Obturator: D≤0.3mm
The tip of Obturator should be
fully out of sleeve when fit.N/A
Insertion
&Cannula
StabilityWhen the obturator pulled out
Trocar sleeve, the friction
should not exceed 5N.N/A
Trocar System
Puncture
PerformanceObturator roughness Ra must
not be bigger than 0.4μm.N/A
Trocar sleeve
retention forceApply a pressure of 5N ± 1N
on both sides of the thread area,
the pull-out force of the sleeve
should not less than 10N.N/A
Air Leakage as a
whole deviceThere should be no leakage
under 4kPa pressure between
stopcock and sealing cap.N/A
Air Leakage
with obturator
withdrawedChoke valve should have good
gas blocking performance.
Bubbles should be less than 20
under 4KPa pressure.N/A
Endoscope
Visualization
QualityAccommodate an appropriately
sided 0° endoscope.N/A
BiocompatibilityIn Vitro Cytotoxicity Test
Skin Sensitization Test
Intracutaneous reactivity Test
Acute Systemic ToxicityN/A

SECTION 6 - 4 of 7

6

Image /page/6/Picture/1 description: The image contains a logo with both Chinese characters and English text. The Chinese characters "风和" are displayed in a teal color, followed by the English word "FENG" in a darker blue. Below the "G" in "FENG", the word "Medical" is written in a smaller font size.

Fengh Medical Co., Ltd.
Trocar

SECTION 6 - 5 of 7

7

Image /page/7/Picture/1 description: The image shows the logo for Fenghe Medical. The logo consists of two Chinese characters followed by the word "FENG" in blue, sans-serif font. To the right of "FENG" is a stylized image of a human figure in blue, with the word "Medical" in smaller font below it.

Fengh Medical Co., Ltd.
Trocar

SECTION 6 - 6 of 7

8

Image /page/8/Picture/1 description: The image shows the logo for FENG Medical. The logo consists of the Chinese characters "风和" on the left, followed by the word "FENG" in blue, and then a stylized "h" inside a circle, also in blue. Below the "h" is the word "Medical" in a smaller font.

Fengh Medical Co., Ltd. 510(k) Submission Trocar

10. Conclusion [21 CFR 807.92(b)(3)]

The Disposable Endoscopic Trocar substantially equivalent to predicate device because both devices use identical technology and same intended use, also testing standards are identical with the predicates. The differences between both devices are insignificant in terms of safety and effectiveness.

SECTION 6 - 7 of 7