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KARL STORZ ICG Imaging System
The KARL STORZ ICG Imaging System is intended to provide real-time visible (VIS) and near-infrared (NIR) fluorescence imaging.

Endoscopic ICG System
Upon intravenous administration and use of ICG consistent with its approved label, the KARL STORZ Endoscopic ICG System enables surgeons to perform minimally invasive surgery using standard endoscopic visible light as well as visual assessment of vessels, blood flow and related tissue perfusion in adults and pediatric patients ≥1 month of age, and at least one of the major extrahepatic bile duct, common bile duct and common hepatic duct) in adults and pediatric patients ≥ 12 years of age, using near infrared imaging in accordance with the appropriately indicated endoscope. Fluorescence imaging of biliary ducts with the KARL STORZ Endoscopic ICG System is intended for use with standard of care white light and, when indicated, intraoperative cholangiography. The device is not intended for standalone use for biliary duct visualization.

Additionally, the KARL STORZ Endoscopic ICG System enables surgeon to perform minimally invasive cranial neurosurgery in adults and pediatrics and endonasal skull base surgery in adults and pediatrics > 6 years of age using standard endoscopic visible light as well as visual assessment of vessels, blood flow and related tissue perfusion using near infrared imaging.

Upon interstitial administration and use of ICG consistent with its approved label, the KARL STORZ Endoscopic ICG System is used to perform intraoperative fluorescence imaging and visualization of the lymphatic system, including lymphatic vessels and lymph nodes.

VITOM II ICG System
The KARL STORZ VITOM II ICG System is intended for capturing fluorescent mages for the visual assessment of blood flow, as an adjunctive method for the evaluation of tissue perfusion, and related tissue-transfer circulation in tissue and free flaps used in plastic, micro- and reconstructive surgical procedures. The VITOM II ICG System is intended to provide a magnified view of the surgical field in standard white light.

KARL STORZ Image1 S CCU
The Imagel S camera control unit (CU) in combination with either a compatible camera head or an appropriately indicated video endoscope is intended for real-time visualization, image recording and documentation during general endoscopic and microscopic procedures in adults and pediatrics.

KARL STORZ ICG Imaging System
The KARL STORZ ICG Imaging System is intended to provide real-time visible (VIS) and near-infrared (NIR) fluorescence imaging for general surgical sites including the abdomen, bile ducts, brain/skull base, and the lymph nodes/lymphatic vessels. Components of the system include:
Scopes:
3D TIPCAM®1 Rubina videoendoscope
26006ACA/BCA, 26616ACA/BCA Rigid Endoscope
26003ACA/ARA/BCA/BRA/FCA/FRA/FCEA/FREA
26046ACA/ARA/BCA/BRA/FCA/FRA
28164AC/BC/FC VITOM II ICG/NIR Telescope
20916025AGA

Light Source:
Power LED Rubina (TL400) Foot Switch (UF101) Fiber Optic Light Cable (495TIP/NCSC/NAC)

Camera Head:
Image1 S 4U Rubina (TH121)

Camera Control Unit (CCU):
Image1 S Connect II (TC201US) Image1 S 4U-Link (TC304US)

KARL STORZ Image1 S CCU
The KARL STORZ IMAGE1 S Camera Control Unit (CCU) is a modular CCU that consists of Image1 S Connect and Connect II modules and the link modules. The Connect modules can be connected to minimum of one and a maximum of three links modules. The modularity enables customers to customize their Image1 S system to their specific video needs.

The Image1 S includes, but not limited to, the following features:
Brightness control Enhancement Control Automatic Light Source Control Shutter Control Image/Video Capture
Seven increments of zoom from 1-2.5x and adaptive zoom
Modules of the Image1 S CCU include: Image1 S Connect (TC200US) Image1 S Connect II (TC201US) Image1 S H3-Link (TC300US) Image1 S X-Link (TC301US) Image1 S D3-Link (TC302US) Image1 S 4U-Link (TC304US)
Accessories to the Image1 S CCU include: Microscope Footswitch (TC019) Image1 S Pilot (TC014) LINK Cable (TC011, TC012)

The provided text describes the regulatory submission for the KARL STORZ ICG Imaging System and KARL STORZ Image 1S Camera Control Unit.

However, the document explicitly states that "Clinical testing was not required to demonstrate substantial equivalence to the predicate devices." This means that the submission does not contain information about a study proving the device meets acceptance criteria based on clinical performance metrics (like sensitivity, specificity, accuracy, or human reader improvement with AI assistance).

The acceptance criteria and performance data mentioned in the document are non-clinical performance data, specifically related to electrical safety, electromagnetic compatibility, and software verification and validation. This type of information is usually presented as compliance with established standards rather than a clinical study with a test set, ground truth, or expert readers.

Therefore, most of the requested information regarding clinical study design (sample size, data provenance, expert ground truth, adjudication, MRMC studies, standalone performance, training set details) cannot be extracted from this document because such a clinical study was not required or provided for this specific submission as per the FDA's determination of substantial equivalence to predicate devices (K212695 and K201135).

Here's what can be extracted and inferred from the document:

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

Based on the "Non-Clinical Performance Data" section, the acceptance criteria are compliance with relevant safety and software standards.

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

• Not applicable / not provided. The document states "Clinical testing was not required." The "performance data" refers to non-clinical engineering and software testing, which does not involve a "test set" of clinical cases in the sense of imaging data for diagnostic performance evaluation.

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 / not provided. No clinical ground truth was established from experts as clinical testing was not required.

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

• Not applicable / not provided. No clinical ground truth was established, therefore no adjudication method was used for clinical interpretation.

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 / not provided. No MRMC study was performed as clinical testing was not required for this submission. The device is an imaging system, not an AI-based diagnostic aid that would assist human readers in interpretation.

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

• Not applicable / not provided. The device is an imaging system, not a standalone diagnostic algorithm. No such performance study was conducted or required.

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

• Not applicable / not provided for clinical performance. For the non-clinical performance data, the "ground truth" or standard was compliance with specified international and FDA-recognized standards for electrical safety, EMC, and software validation.

8. The sample size for the training set

• Not applicable / not provided. As this is an imaging system and not an AI/ML-based diagnostic algorithm, there is no mention of a "training set" of data in the context of machine learning model development. The software testing mentioned refers to standard software verification and validation, not machine learning model training.

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

• Not applicable / not provided. See above.

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