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510(k) Data Aggregation

    K Number
    K050163
    Date Cleared
    2005-03-24

    (58 days)

    Product Code
    Regulation Number
    876.1500
    Reference & Predicate Devices
    Why did this record match?
    Device Name :

    HENKE SASS WOLF OF AMERICA BARIATRIC LAPAROSCOPE

    AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
    Intended Use

    The Henke Sass Wolf of America HSW Bariatric Laparoscope is intended to be used in general laparoscopic surgery. Laparoscopic surgery is a means of performing diagnostic and therapeutic surgical procedures intra-abdominally using equipment that minimizes surgical invasiveness. Rather than creating large incisions to gain access to surgical sites, surgeons view inside the body and operate by using instruments inserted through small skin punctures (inserted through the laparoscope or through another small incision). This includes, but is not limited to such uses as gallbladder and appendix removal, hernia repair, and examination of the abdominal cavity, appendix, gallbladder, and liver.

    Bariatric laparoscopes are intended to be used to perform surgical procedures on morbidly obese segments of the patient population.

    Device Description

    The Henke Sass Wolf of America's Bariatric Laparoscope is identical in terms of materials and modes of construction, optical performance and safety to Henke Sass Wolf GmbH HSW Laparoscopy Set - K941967 and the Stryker - K993045. This Bariatric version is longer (up to 550mm) so that it is capable of performing the same types of procedures on morbidly obese segments of the patient population.

    Diameter: 5mm - 10mm
    Length: 280mm to 550mm
    Direction of View: 0, 30, 45 Degrees
    Field of View: 75 Degrees
    Shaft: 300 Series Stainless Steel
    Body: Stainless Steel
    Sidearm: Stainless Steel
    Eyepiece: P.E.E.K.
    Lenses: Glass or Sapphire

    Adapters for connection to all conventional light-guides are supplied as standard.

    The device is intended to be sterilized prior to use. The Bariatric Laparoscopes are designed to facilitate cleaning and disinfection as were the predicate devices. There is no difference in design and material that would impact the sterilization validation conducted for the HSW predicate device.

    Instructions for cleaning and sterilization are included in the instructions for use. Sterilization and disinfection validation for predicate devices included EtO, Steris, and Sterrad is performed to assure an SAL of 10-6 per AAMI / ISO Standards.

    AI/ML Overview

    The provided text is a 510(k) premarket notification for a medical device, specifically a bariatric laparoscope. This type of submission focuses on demonstrating substantial equivalence to a legally marketed predicate device, rather than proving safety and effectiveness through clinical trials with detailed acceptance criteria and performance metrics in the way that a new, high-risk device might.

    Therefore, much of the requested information about a study that proves the device meets acceptance criteria (e.g., sample sizes for test/training sets, number and qualifications of experts, adjudication methods, MRMC studies, standalone performance, type of ground truth) is not applicable to this type of regulatory submission or the information presented in the document.

    The document primarily states that the proposed device is substantially equivalent to existing predicate devices based on design, materials, manufacturing methods, and intended use. The "acceptance criteria" here are essentially the requirements for demonstrating substantial equivalence as per FDA regulations.

    Here's an attempt to answer the questions based only on the provided text, while acknowledging the limitations for a 510(k) submission:


    1. A table of acceptance criteria and the reported device performance

    For a 510(k) submission, "acceptance criteria" are not typically stated as quantified performance targets but rather as demonstrating equivalence to predicate devices. The "performance" is implicitly deemed equivalent if the device meets the characteristics and testing mentioned.

    Acceptance Criteria (Implied for 510(k) Substantial Equivalence)Reported Device Performance/Compliance
    Intended Use Equivalence: Same indications for use as predicate devices.The Henke Sass Wolf Bariatric Laparoscope shares the same general laparoscopic surgery indications as the predicate devices (gallbladder/appendix removal, hernia repair, examination of abdominal cavity, appendix, gallbladder, and liver). It adds an intention to be used on morbidly obese patients, which is also an indication for one of the predicate devices (Stryker Bariatric Laparoscopes, K993045).
    Technological Characteristics Equivalence: Similar design, materials, and operational principles.The device is "identical in terms of materials and modes of construction, optical performance and safety" to the Henke Sass Wolf GmbH HSW Laparoscopy Set (K941967) and the Stryker (K993045). It is longer (up to 550mm) to accommodate bariatric procedures, but this is presented as a variation of an existing feature (length) to serve a specific patient population, which is also covered by one of the predicate devices. The specific dimensions, materials (stainless steel, PEEK, glass/sapphire), and direction/field of view are also specified and implicitly align with industry standards or predicate features.
    Safety Testing: Compliance with relevant safety and sterilization standards.Biological Evaluation: Successfully met requirements of ISO 10993-1, ISO 10993-5, ISO 10993-12.
    Electrical Safety: Successfully met requirements of IEC 601-2-18 (BF or CF applied part).
    Sterilization: Successfully met AAMI/ISO Standards for Sterilization of Medical Devices. Validation conducted for predicate device included EtO, Steris, and Sterrad to assure an SAL of 10^-6. No difference in design/material that would impact this validation.
    No New Issues of Safety or Effectiveness: The device does not raise new questions of safety or effectiveness."The HSW Bariatric Laparoscope does not introduce new issues when compared to its predicate devices or uses."

    2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

    Not applicable. This is a 510(k) submission for a medical device (laparoscope), not an AI/software device requiring a "test set" of clinical data for performance evaluation in the typical sense. The "testing" referred to是在工程和生物相容性层面上进行的物理和材料测试,而不是基于临床数据集的性能评估。

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

    Not applicable. See point 2.

    4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

    Not applicable. See point 2.

    5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

    Not applicable. This device is a physical surgical instrument (laparoscope), not an imaging AI diagnostic aid.

    6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

    Not applicable. This device is a physical surgical instrument, not an algorithm.

    7. The type of ground truth used (expert concensus, pathology, outcomes data, etc)

    Not applicable in the context of clinical performance data. The "ground truth" for this submission revolves around established engineering standards (e.g., ISO for biocompatibility, IEC for electrical safety, AAMI/ISO for sterilization) and the established characteristics and safety profile of the predicate devices.

    8. The sample size for the training set

    Not applicable. This device is a physical surgical instrument, not an AI/software device requiring a "training set."

    9. How the ground truth for the training set was established

    Not applicable. See point 8.

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