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The ePlus Skin Treatment system is intended for dermatological procedures.

The DS applicator is indicated for the removal of unwanted hair from skin types I-VI, and to effect stable long-term, or permanent, hair reduction*.

The DSL applicator is indicated for hair removal, permanent hair reduction*. The applicator is intended for use on all skin types, (Fitzpatrick skin type I-VI), including tanned skin.

The LV applicator is indicated for treatment of vascular lesions.

The LVA applicator is indicated for treatment of vascular lesions.

The WRA applicator is indicated for non invasive wrinkles treatment.

The SR applicator is intended for superficial benign vascular and pigmented lesion treatment such as:

lentigines, freckles, telangiectasia, rosacea, poikiloderma, angioma, sun spots and age spots.

The SR treatment may be performed on body areas such as the face, chest, hands and arms. It can be also performed on sporadic lesions anywhere on the body.

The SRA applicator is intended for superficial benign vascular and pigmented lesion treatment such as:

lentigines. freckles, telangiectasia, rosacea, poikiloderma. angioma, sun spots and age spots.

The SRA treatment may be performed on body areas such as the face, chest, hands and arms. It can be also performed on sporadic lesions anywhere on the body.

The AC applicator is indicated for the treatment of moderate inflammatory acne vulgaries.

The Sublative RF applicator is indicated for Dermatological procedures requiring ablation and resurfacing of the skin, and for the treatment of facial wrinkles.

The Sublime applicator is indicated for non invasive wrinkles treatment.

• Permanent hair reduction is defined as the long-term, stable reduction in the number of hairs regrowing when measured at 6, 9, and 12 months after the completion of a treatment regimen

The ePlus skin treatment system is a multi-application system that provides a variety of skin treatments. The system combines Syneron's previously cleared Polaris, Aurora and eTwo treatment Systems and their applicators. The ePlus skin treatment system delivers two ranges of electromagnetic energy to the skin tissue through the system applicators:

• Optical radiation through Laser or IPL (Intense Pulse Light) in the visible & near-IR range.

2. RF current conducted through the tissue at 1MHz

The provided document is a 510(k) summary for the Syneron ePlus Skin Treatment System. It focuses on demonstrating substantial equivalence to predicate devices rather than presenting new clinical studies with detailed acceptance criteria and performance data. Therefore, many of the requested details about specific study design elements (e.g., sample sizes, expert qualifications, adjudication methods, MRMC studies, standalone performance, training set details) are not explicitly present in the document because they were not required for this type of submission.

Here's an analysis based on the information available:

1. Table of Acceptance Criteria and Reported Device Performance

The document does not present a table of specific acceptance criteria in terms of quantitative performance metrics (e.g., sensitivity, specificity, accuracy) for the ePlus Skin Treatment System itself. Instead, the "acceptance criteria" for the 510(k) clearance process were met through demonstrating substantial equivalence to previously cleared predicate devices and compliance with safety standards.

• Acceptance Criteria (Implicit for 510(k) Clearance):

  • Substantial equivalence to predicate devices in intended use and technical performance.
  • Compliance with recognized safety and electromagnetic compatibility standards (IEC 60601-1, IEC 60601-2-2, IEC 60601-2-22, IEC 60825-1, IEC 60601-1-2 Ed. 2.1).

• Reported Device Performance:
  The document states: "The safety and efficacy of the ePlus Skin Treatment System was evaluated in the clearance process of the predicate devices that use the same applicators that are part of this device. Syneron believes that clinical data is not required to determine the safety and efficacy of the ePlus Skin Treatment System since the intended use and technical performance of ePlus and its applicators are equivalent to the predicate devices."

  Therefore, the reported performance is implied to be equivalent to that of the predicate devices listed for each applicator, which had already demonstrated safety and effectiveness for their respective indications. The specific performance metrics (e.g., hair reduction percentages, lesion clearance rates) for the predicate devices are not detailed in this 510(k) summary.

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

The document explicitly states: "Syneron believes that clinical data is not required to determine the safety and efficacy of the ePlus Skin Treatment System since the intended use and technical performance of ePlus and its applicators are equivalent to the predicate devices."

This indicates that no new clinical test set was used for the ePlus Skin Treatment System itself to demonstrate its safety and efficacy for this 510(k) submission. The safety and efficacy data were derived from the clearance processes of the predicate devices. Therefore, details like sample size, data provenance (country, retrospective/prospective), and ground truth establishment for a new test set are not applicable here.

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

Not applicable, as no new test set was used for the ePlus Skin Treatment System in this 510(k) process. The effectiveness and safety were supported by data from the predicate devices.

4. Adjudication Method for the Test Set

Not applicable, as no new test set was used for the ePlus Skin Treatment System in this 510(k) process.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done, and Effect Size of Human Improvement with AI vs. Without AI Assistance

Not applicable. The ePlus Skin Treatment System is a medical device for dermatological procedures (laser/IPL and RF energy delivery), not an AI-powered diagnostic or assistive tool. Therefore, an MRMC study comparing human readers with and without AI assistance is not relevant to this device.

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

Not applicable. This device is an energy delivery system used by a human operator, not an algorithm, and thus does not have "standalone" algorithmic performance in the context of AI or diagnostic systems.

7. The Type of Ground Truth Used (Expert Consensus, Pathology, Outcomes Data, etc.)

The ground truth for the predicate devices' original clinical studies (which supported their initial clearance and thus implicitly support this 510(k)) would have varied depending on the indication:

• Hair Reduction: Likely involved objective measurements of hair count reduction over time (e.g., 6, 9, 12 months post-treatment) and potentially photographic assessment, possibly with expert review.
• Vascular/Pigmented Lesions: Likely involved clinical assessment by dermatologists/physicians, potentially photographic documentation, and
  • For benign pigmented lesions, visual assessment by experts might be sufficient.
  • For vascular lesions, visual assessment and potentially quantitative measures (e.g., lesion area reduction) or subjective improvement scores.
• Wrinkle Treatment: Typically involves objective measures like wrinkle severity scales (e.g., Glogau scale) or optical profilometry, along with subjective patient satisfaction and physician assessment.
• Acne Treatment: Typically involves counting inflammatory and non-inflammatory lesions (comedones, papules, pustules, nodules) and assessing global severity scores.
• Ablation and Resurfacing: Involves clinical assessment of skin texture, resurfacing depth, and healing, potentially with histological examination.

However, these details are not provided within this 510(k) document for the ePlus system, as it relies on previous clearances.

8. The Sample Size for the Training Set

Not applicable. As noted, no new clinical studies were conducted for the ePlus system as presented in this 510(k). The system itself is an energy delivery device, not a machine learning model requiring a training set in the AI sense.

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

Not applicable. (See point 8).

In summary: The Syneron ePlus Skin Treatment System obtained 510(k) clearance by demonstrating substantial equivalence to previously cleared predicate devices whose safety and efficacy had already been established through their own respective clearance processes. Therefore, this 510(k) summary does not include new clinical study data with specific acceptance criteria, sample sizes, expert qualifications, or detailed ground truth establishment methods for the ePlus system itself. Instead, it references the prior clearances and compliance with general safety standards.

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The eTwo Skin Treatment system is intended for dermatological procedures.

The Sublative RF applicator is indicated for Dermatological procedures requiring ablation and resurfacing of the skin, and for the treatment of facial wrinkles.

The Sublime applicator is indicated for non invasive wrinkles treatment.

The eTwo skin treatment system is a mobile operating system combining two treatment applicators:

• . Sublative RF applicator, which is intended for dermatological procedures requiring ablation and resurfacing of the skin and for ablation and resurfacing of the skin for wrinkle treatment. Sublative RF's technology enables skin remodeling with minimal downtime. In fractional treatment, small damaged areas are created in the skin, accelerating tissue healing process after treatment.
• Sublime applicator, which is intended for non invasive wrinkles treatment. The applicator uses pulsed infrared light combined with RF energy for Deep Tissue Stimulation leading to skin tightening. Thermal stimulation of the deep dermis contributes to collagen enrichment and tissue remodeling.

The provided document states: "Syneron believes that clinical data is not required to determine the safety and efficacy of the eTwo Skin Treatment System."

Therefore, this device does not have a study proving it meets acceptance criteria, as no clinical performance data was provided.

Consequently, none of the requested information (performance table, sample sizes, expert qualifications, adjudication methods, MRMC studies, standalone performance, ground truth details, or training set sample size) can be extracted from the provided text.

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