K Number
K243182
Device Name
Anovo Instrument ARM Curved Scissors; Anovo Instrument ARM Hook Electrode
Date Cleared
2025-02-03

(126 days)

Product Code
Regulation Number
878.4961
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdparty
Intended Use
The Anovo™ Instrument ARM Curved Scissors is indicated for use for tissue manipulation including cutting, dissecting, and coagulating and cutting using monopolar energy. The Anovo™ Instrument ARM Hook Electrode is indicated for use for tissue manipulation including dissecting, and coagulating and cutting using monopolar energy. The Anovo™ Instrument ARM Curved Scissors and the Anovo™ Instrument ARM Hook Electrode are intended for use with the Anovo™ Surgical System. The Anovo™ Surgical System is an endoscopic instrument control system that is intended to assist in the accurate control of the Instrument ARMs during single site, natural orifice laparoscopic-assisted transvaginal benign surgical procedures listed below. The Anovo™ Surgical System is indicated for use in adult patients. It is intended to be used by trained physicians in an operating room environment. The representative uses of the Anovo™ Surgical System are indicated for the following benign procedures: - · Total Benign Hysterectomy with Salpingo-Oophorectomy - · Total Benign Hysterectomy with Salpingectomy - · Total Benign Hysterectomy - · Salpingectomy - · Oophorectomy - · Adnexectomy - · Ovarian cyst removal
Device Description
The Anovo™ Instrument ARM Curved Scissors and Anovo™ Instrument ARM Hook Electrode are optional instruments for the Anovo™ Surgical System Model 6N. The Anovo™ Surgical System Model 6N with Instrument ARM Grasper end-effector ("Predicate Device") was the subject of a De Novo request (DEN190022) for transvaginal access to gynecological procedures and was granted a marketing authorization in February 2021. Both the Anovo™ Instrument ARM Curved Scissors and Hook Electrode are intended to be used with the Anovo™ Surgical System. The Anovo™ Surgical System comprises the Anovo™ Surgeon Console operated by a nonsterile surgeon, two sterile instruments (Instrument ARMS) actuated by the non-sterile, Anovo™ Robotic Control Unit (RCU). The system allows the physician to operate the Instrument ARMS from the Anovo™ Surgeon Console by manipulating the ARMS Controllers under visual guidance. No changes were made to the Anovo™ Surgical System for the scope of this submission.
More Information

Not Found

No
The summary describes a robotic surgical system for controlling instruments, but there is no mention of AI or ML in the device description, intended use, or performance studies. The system appears to be a direct control system operated by a physician.

Yes
The device is described as an endoscopic instrument control system and associated tools (scissors, hook electrode) intended to assist in surgical procedures like hysterectomy and oophorectomy, which are therapeutic interventions.

No.
The device is described as surgical instruments (scissors and hook electrode) for tissue manipulation (cutting, dissecting, coagulating) and a control system for these instruments during surgical procedures. There is no mention of it being used for diagnosis, disease detection, or medical assessment.

No

The device description explicitly states that the Anovo™ Surgical System comprises a Surgeon Console, two sterile instruments (Instrument ARMS), and a Robotic Control Unit (RCU). This indicates the presence of significant hardware components, not just software.

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

Here's why:

  • Intended Use: The intended use clearly describes the device as being used for surgical procedures (tissue manipulation, cutting, dissecting, coagulating) within the human body. IVDs are used to examine specimens (like blood, urine, or tissue samples) outside of the body to provide information about a person's health.
  • Device Description: The description details a surgical system with robotic arms and instruments used for direct interaction with tissue during surgery. This is consistent with a surgical device, not an IVD.
  • Anatomical Site: The specified anatomical site is the pelvic cavity, indicating use within the body.
  • Performance Studies: The performance studies described (bench testing, animal study, thermal damage, biocompatibility) are typical for surgical devices, focusing on mechanical function, safety during surgery, and interaction with tissue. IVD performance studies would involve evaluating the accuracy and reliability of tests performed on biological samples.

Therefore, the Anovo™ Instrument ARM Curved Scissors and Anovo™ Instrument ARM Hook Electrode, as part of the Anovo™ Surgical System, are surgical instruments and not IVDs.

N/A

Intended Use / Indications for Use

The Anovo™ Instrument ARM Curved Scissors is indicated for use for tissue manipulation including cutting, dissecting, and coagulating and cutting using monopolar energy.

The Anovo™ Instrument ARM Hook Electrode is indicated for use for tissue manipulation including dissecting, and coagulating and cutting using monopolar energy.

The Anovo™ Instrument ARM Curved Scissors and the Anovo™ Instrument ARM Hook Electrode are intended for use with the Anovo™ Surgical System.

The Anovo™ Surgical System is an endoscopic instrument control system that is intended to assist in the accurate control of the Instrument ARMS during single site, natural orifice laparoscopic-assisted transvaginal benign surgical procedures listed below.

The Anovo™ Surgical System is indicated for use in adult patients. It is intended to be used by trained physicians in an operating room environment. The representative uses of the Anovo™ Surgical System are indicated for the following benign procedures:

  • Total Benign Hysterectomy with Salpingo-Oophorectomy
  • Total Benign Hysterectomy with Salpingectomy
  • Total Benign Hysterectomy
  • Salpingectomy
  • Oophorectomy
  • Adnexectomy
  • Ovarian cyst removal

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

QNM

Device Description

The Anovo™ Instrument ARM Curved Scissors and Anovo™ Instrument ARM Hook Electrode are optional instruments for the Anovo™ Surgical System Model 6N. The Anovo™ Surgical System Model 6N with Instrument ARM Grasper end-effector ("Predicate Device") was the subject of a De Novo request (DEN190022) for transvaginal access to gynecological procedures and was granted a marketing authorization in February 2021. Both the Anovo™ Instrument ARM Curved Scissors and Hook Electrode are intended to be used with the Anovo™ Surgical System. The Anovo™ Surgical System comprises the Anovo™ Surgeon Console operated by a nonsterile surgeon, two sterile instruments (Instrument ARMS) actuated by the non-sterile, Anovo™ Robotic Control Unit (RCU). The system allows the physician to operate the Instrument ARMS from the Anovo™ Surgeon Console by manipulating the ARMS Controllers under visual guidance. No changes were made to the Anovo™ Surgical System for the scope of this submission.
Both the subject and predicate devices are sterile, single use component, inserted transvaginally into the pelvic cavity to manipulate the tissue and perform the surgery. Each Instrument ARM consists of an End Effector, a flexible section (joints), a rigid section, and a handle. The only difference between the subject and predicate devices is the endeffector and the type of electrosurgery energy. The predicate device includes Grasper end-effector and it is powered by bipolar and monopolar electrosurgery energy, while the subject devices include Curved Scissors and Hook Electrode end-effectors and they are powered only by monopolar energy. Importantly, there are no changes to the Anovo™ Instrument ARM Grasper, the RCU, or the other components of the Anovo™ Surgical System related to the optional Instrument ARMs that are the subject of this submission and no changes to the user interface. Moreover, there are no differences in the procedure for use of the Instrument ARMs. Two Instrument ARMs are connected to the Robotic Control Unit, each of which corresponds to the respective hand of the surgeon as controlled by right or left ARMs Controllers.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

pelvic cavity

Indicated Patient Age Range

adult patients

Intended User / Care Setting

trained physicians in an operating room environment.

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)

Bench Testing: Bench testing demonstrates that the subject device's design output meets the design input requirements. The testing conducted consisted of mechanical and functional verification.

Pre-Clinical Animal Study: Momentis has performed design validation of the Anovo™ Instrument ARM Hook Electrode and Anovo™ Instrument ARM Curved Scissors in three (3) sheep (ewe) model to ensure that the Anovo™ Instrument ARM Hook Electrode and Anovo™ Instrument ARM Curved Scissors meet their safety and efficiency performance requirements. The results were analyzed and demonstrated that the safety and performance of the Monopolar Instruments ARM Hook Electrode and Curved Scissors that were used with the Anovo™ Surgical System Model 6N, in performing the required surgical tasks in transvaginal laparoscopic gynecologic procedures were demonstrated successfully.

Thermal Damage: Thermal effects testing on ex vivo animal tissue was performed to evaluate the thermal effects on tissue caused by the electrosurqical functionalities of the Anovo™ Instrument ARM Hook Electrode and Anovo™ Instrument ARM Curved Scissors. This testing was designed in accordance with FDA's Guidance Document, Premarket Notification (510(k)) Submissions for Electrosurgical Devices for General Surgery (March 2020) and Draft Guidance Evaluation of Thermal Effects of Medical Devices that Produce Tissue Heating and/or Cooling (March 2024). Specifically, thermal spread on representative tissue samples by the subject device electrosurgical features were compared through independent histopathological analysis to that of comparable FDA-cleared off-the-shelf tools, and it was demonstrated that the thermal effects of the Anovo™ Instrument ARM Hook Electrode and Anovo™ Instrument ARM Curved Scissors is equivalent to that of the cleared devices.

Biocompatibility: Biocompatibility testing was performed according to ISO 10993-1:2018 and FDA guidance "Biological evaluation of medical devices-Part 1: Evaluation and testing within a risk management process", September 2023 requirements including the following tests: Cytotoxicity, Irritation, Sensitization, Acute Systemic Toxicity, Material-Mediated Pyrogenicity, Hemolysis.

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

Not Found

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

DEN190022

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

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

§ 878.4961 Mountable electromechanical surgical system for transluminal approaches.

(a)
Identification. A mountable electromechanical surgical system for transluminal approaches is a software-controlled, patient bed- and/or operating table-mounted electromechanical surgical system with human/device interfaces that allows a qualified user to perform transluminal endoscopic or laparoscopic surgical procedures using surgical instruments attached to an electromechanical arm.(b)
Classification. Class II (special controls). The special controls for this device are:(1) The device manufacturer must develop, and update as necessary, a device-specific use training program that ensures proper device setup/use/shutdown, accurate control of instruments to perform the intended surgical procedures, troubleshooting and handling during unexpected events or emergencies, and safe practices to mitigate use error.
(2) The device manufacturer may only distribute the device to facilities that implement and maintain the device-specific use training program and ensure that users of the device have completed the device-specific use training program.
(3) The device manufacturer must conduct and complete post-market surveillance, including an impact of the training program on user learning, behavior, and performance, in accordance with an FDA-agreed-upon protocol. The device manufacturer must submit post-market surveillance reports that contain current data and findings in accordance with the FDA-agreed-upon protocol.
(4) The device manufacturer must submit a report to FDA annually on the anniversary of initial marketing authorization for the device, until such time as FDA may terminate such reporting, which comprises the following information:
(i) Cumulative summary, by year, of complaints and adverse events since date of initial marketing authorization; and
(ii) Identification and rationale for changes made to the device, labeling or device-specific use training program, which did not require submission of a premarket notification during the reporting period.
(5) Labeling must include:
(i) A detailed summary of clinical performance testing conducted with the device, including study population, results, adverse events, and comparisons to any comparator groups identified;
(ii) A statement in the labeling that the safety and effectiveness of the device has not been evaluated for outcomes related to the treatment or prevention of cancer, including but not limited to risk reduction, overall survival, disease-free survival and local recurrence, unless FDA determines that it can be removed or modified based on clinical performance data submitted to FDA;
(iii) Identification of compatible devices;
(iv) The list of surgical procedures for which the device has been determined to be safe with clinical justification;
(v) Reprocessing instructions for reusable components;
(vi) A shelf life for any sterile components;
(vii) A description of the device-specific use training program;
(viii) A statement that the device is only for distribution to facilities that implement and maintain the device-specific use training program and ensure that users of the device have completed the device-specific use training program; and
(ix) A detailed summary of the post-market surveillance data collected under paragraph (b)(3) of this section and any necessary modifications to the labeling to accurately reflect outcomes based upon the post-market surveillance data collected under paragraph (b)(3) of this section.
(6) Clinical performance testing must demonstrate that the device performs as intended under anticipated conditions of use.
(7) Human factors validation testing must be performed and must demonstrate that the user interfaces of the system support safe use in an operating room environment.
(8) Non-clinical performance testing must demonstrate that the device performs as intended under anticipated conditions of use and must include:
(i) Device motion accuracy and precision;
(ii) System testing;
(iii) Instrument reliability;
(iv) Thermal effects on tissue;
(v) Human-device interface;
(vi) Mounting hardware testing;
(vii) Workspace access testing; and
(viii) Performance testing with compatible devices.
(9) Software verification, validation, and hazard analysis must be performed. Software documentation must include an assessment of the impact of threats and vulnerabilities on device functionality and end users/patients as part of cybersecurity review.
(10) Electromagnetic compatibility and electrical, thermal, and mechanical safety testing must be performed.
(11) Performance data must demonstrate the sterility of all patient-contacting device components.
(12) Performance data must support the shelf life of the device components provided sterile by demonstrating continued sterility and package integrity over the labeled shelf life.
(13) Performance data must validate the reprocessing instructions for the reusable components of the device.
(14) Performance data must demonstrate that all patient-contacting components of the device are biocompatible.
(15) Performance data must demonstrate that all patient-contacting components of the device are non-pyrogenic.

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February 3, 2025

Momentis Surgical Ltd. Maya Leib Shlomo, VP of QA/RA 6 Yoni Netanyahu Street Or Yehuda, 6037604 Israel

Re: K243182

Trade/Device Name: Anovo Instrument ARM Curved Scissors; Anovo Instrument ARM Hook Electrode Regulation Number: 21 CFR 878.4961 Regulation Name: Mountable Electromechanical Surgical System For Transluminal Approaches Regulatory Class: Class II Product Code: QNM Dated: September 30, 2024 Received: September 30, 2024

Dear Maya Leib Shlomo:

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 (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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database available at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device"

1

(https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30. Design controls; 21 CFR 820.90. Nonconforming product; and 21 CFR 820.100, Corrective and preventive action. Please note that regardless of whether a change requires premarket review, the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

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 Part 803) for devices or postmarketing safety reporting (21 CFR Part 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

All medical devices, including Class I and unclassified devices and combination product device constituent parts are required to be in compliance with the final Unique Device Identification System rule ("UDI Rue"). The UDI Rule requires, among other things, that a device bear a unique device identifier (UDI) on its label and package (21 CFR 801.20(a)) unless an exception or alternative applies (21 CFR 801.20(b)) and that the dates on the device label be formatted in accordance with 21 CFR 801.18. The UDI Rule (21 CFR 830.300(a) and 830.320(b)) also requires that certain information be submitted to the Global Unique Device Identification Database (GUDID) (21 CFR Part 830 Subpart E). For additional information on these requirements, please see the UDI System webpage at https://www.fda.gov/medical-devices/device-advicecomprehensive-regulatory-assistance/unique-device-identification-system-udi-system.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). 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 (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

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Sincerely,

Digitally signed by Mark Mark Trumbore -S Trumbore -S 09:53:08-05'00'

Mark Trumbore, Ph.D. Assistant Director DHT4A: Division of General Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

Submission Number (if known)

K243182

Device Name

Anovo Instrument ARM Curved Scissors:

Anovo Instrument ARM Hook Electrode

Indications for Use (Describe)

The Anovo™ Instrument ARM Curved Scissors is indicated for use for tissue manipulation including cutting, dissecting, and coagulating and cutting using monopolar energy.

The Anovo™ Instrument ARM Hook Electrode is indicated for use for tissue manipulation including dissecting, and coagulating and cutting using monopolar energy.

The Anovo™ Instrument ARM Curved Scissors and the Anovo™ Instrument ARM Hook Electrode are intended for use with the Anovo™ Surgical System.

The Anovo™ Surgical System is an endoscopic instrument control system that is intended to assist in the accurate control of the Instrument ARMS during single site, natural orifice laparoscopicassisted transvaginal benign surgical procedures listed below.

The Anovo™ Surgical System is indicated for use in adult patients. It is intended to be used by trained physicians in an operating room environment. The representative uses of the Anovo™ Surgical System are indicated for the following benign procedures:

  • · Total Benign Hysterectomy with Salpingo-Oophorectomy
  • · Total Benign Hysterectomy with Salpingectomy
  • · Total Benign Hysterectomy
  • · Salpingectomy
  • · Oophorectomy
  • · Adnexectomy
  • · Ovarian cyst removal

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

Prescription Use (Part 21 CFR 801 Subpart D)

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

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| Submitter | Momentis Surgical Ltd.
6 Yoni Netanyahu St.
Or Yehuda, Israel 6037604 |
|----------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact Person: | Maya Leib Shlomo, VP of QA/RA
Maya.leib@momentissurgical.com
Tel.: 972-5-088-52822 |
| Date: | September 30, 2024 |
| Device Name: | Anovo™ Instrument ARM Curved Scissors and Anovo™ Instrument ARM
Hook Electrode |
| Classification: | Mountable Electromechanical Surgical System for Transluminal Approachs
Product Code QNM, Class 2 |
| Predicate Device: | Anovo™ Instrument ARM Grasper end-effector (DEN190022) |
| Description: | The Anovo™ Instrument ARM Curved Scissors and Anovo™ Instrument ARM
Hook Electrode are optional instruments for the Anovo™ Surgical System
Model 6N.
The Anovo™ Surgical System Model 6N with Instrument ARM Grasper end-
effector ("Predicate Device") was the subject of a De Novo request
(DEN190022) for transvaginal access to gynecological procedures and was
granted a marketing authorization in February 2021. Both the Anovo™
Instrument ARM Curved Scissors and Hook Electrode are intended to be used
with the Anovo™ Surgical System.
The Anovo™ Surgical System comprises the Anovo™ Surgeon Console
operated by a nonsterile surgeon, two sterile instruments (Instrument ARMS)
actuated by the non-sterile, Anovo™ Robotic Control Unit (RCU). The system
allows the physician to operate the Instrument ARMS from the Anovo™
Surgeon Console by manipulating the ARMS Controllers under visual
guidance. No changes were made to the Anovo™ Surgical System for the
scope of this submission. |
| Indications for Use: | The Anovo™ Instrument ARM Curved Scissors is indicated for use for tissue
manipulation including cutting, dissecting, and coagulating and cutting using
monopolar energy. |

5

The Anovo™ Instrument ARM Hook Electrode is indicated for use for tissue manipulation including dissecting, and coagulating and cutting using monopolar energy.

The Anovo™ Instrument ARM Curved Scissors and the Anovo™ Instrument ARM Hook Electrode are intended for use with the Anovo™ Surgical System.

The Anovo™ Surgical System is an endoscopic instrument control system that is intended to assist in the accurate control of the Instrument ARMs during single site, natural orifice laparoscopic-assisted transvaginal benign surgical procedures listed below. The Anovo™ Surgical System is indicated for use in adult patients. It is intended to be used by trained physicians in an operating room environment.

The representative uses of the Anovo™ Surgical System are indicated for the following benign procedures:

  • Total benign hysterectomy with salpingo-oophorectomy ●
  • . Total benign hysterectomy with salpingectomy
  • Total benign hysterectomy
  • Salpingectomy .
  • Oophorectomy
  • . Adnexectomy
  • . Ovarian cyst removal

Comparison of Technological Characteristics:

Both the subject and predicate devices are sterile, single use component, inserted transvaginally into the pelvic cavity to manipulate the tissue and perform the surgery. Each Instrument ARM consists of an End Effector, a flexible section (joints), a rigid section, and a handle.

The only difference between the subject and predicate devices is the endeffector and the type of electrosurgery energy. The predicate device includes Grasper end-effector and it is powered by bipolar and monopolar electrosurgery energy, while the subject devices include Curved Scissors and Hook Electrode end-effectors and they are powered only by monopolar energy.

Importantly, there are no changes to the Anovo™ Instrument ARM Grasper, the RCU, or the other components of the Anovo™ Surgical System related to the optional Instrument ARMs that are the subject of this submission and no changes to the user interface. Moreover, there are no differences in the procedure for use of the Instrument ARMs. Two Instrument ARMs are

6

connected to the Robotic Control Unit, each of which corresponds to the respective hand of the surgeon as controlled by right or left ARMs Controllers.

Performance Evaluation:

The following performance testing was conducted to demonstrate substantial equivalence to the predicate device:

Bench Testing

Bench testing demonstrates that the subject device's design output meets the design input requirements. The testing conducted consisted of mechanical and functional verification.

Pre-Clinical Animal Study

Momentis has performed design validation of the Anovo™ Instrument ARM Hook Electrode and Anovo™ Instrument ARM Curved Scissors in three (3) sheep (ewe) model to ensure that the Anovo™ Instrument ARM Hook Electrode and Anovo™ Instrument ARM Curved Scissors meet their safety and efficiency performance requirements.

The results were analyzed and demonstrated that the safety and performance of the Monopolar Instruments ARM Hook Electrode and Curved Scissors that were used with the Anovo™ Surgical System Model 6N, in performing the required surgical tasks in transvaginal laparoscopic gynecologic procedures were demonstrated successfully.

Thermal Damage

Thermal effects testing on ex vivo animal tissue was performed to evaluate the thermal effects on tissue caused by the electrosurqical functionalities of the Anovo™ Instrument ARM Hook Electrode and Anovo™ Instrument ARM Curved Scissors. This testing was designed in accordance with FDA's Guidance Document, Premarket Notification (510(k)) Submissions for Electrosurgical Devices for General Surgery (March 2020) and Draft Guidance Evaluation of Thermal Effects of Medical Devices that Produce Tissue Heating and/or Cooling (March 2024).

Specifically, thermal spread on representative tissue samples by the subject device electrosurgical features were compared through independent histopathological analysis to that of comparable FDA-

7

cleared off-the-shelf tools, and it was demonstrated that the thermal effects of the Anovo™ Instrument ARM Hook Electrode and Anovo™ Instrument ARM Curved Scissors is equivalent to that of the cleared devices.

Biocompatibility

Biocompatibility testing was performed according to ISO 10993-1:2018 and FDA guidance "Biological evaluation of medical devices-Part 1: Evaluation and testing within a risk management process", September 2023 requirements including the following tests:

  • . Cytotoxicity
  • . Irritation
  • Sensitization .
  • Acute Systemic Toxicity .
  • Material-Mediated Pyrogenicity .
  • Hemolysis

The subject devices are additional optional accessories for use with the Conclusion: Anovo™ Surgical System Model 6N in addition to the predicate Instrument ARM with Grasper end-effector previously cleared for use with the Anovo™ Surgical System (DEN190022). The subject devices and the predicate device have the same indication for use, similar intended use and principles of operation, and the same technological characteristics. The minor technological differences between the Anovo™ Instrument ARM Curved Scissors and Anovo™ Instrument ARM Hook Electrode and its predicate device raise no new questions of safety or effectiveness. The results of the performance data, including bench testing, pre-clinical Animal testing, and tissue thermal damage provide reasonable assurance of safety and effectiveness of the device for its proposed intended use and demonstrate that the Anovo™ Instrument ARM Curved Scissors and Anovo™ Instrument ARM Hook Electrode are as safe as the Anovo™ Instrument ARM Grasper end-effector, its predicate device. Thus, the Anovo™ Instrument ARM Curved Scissors and Anovo™

Instrument ARM Hook Electrode are substantially equivalent to the Anovo™ Instrument ARM Grasper end-effector.