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510(k) Data Aggregation

    K Number
    K103155
    Date Cleared
    2011-10-28

    (367 days)

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

    SUMO ACCESS AND TISSUE RESECTION SYSTEM

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

    The SuMO™ Access and Tissue Resection System is intended to access, dissect, and resect soft tissue in endoscopic gastrointestinal procedures such as removal of flat polyps.

    The Injection Needle is intended for endoscopic injection of solutions such as a procedural aid in endoscopic procedures.

    The Tunneling Balloon is intended for soft tissue separation and dilation during endoscopic procedures.

    The Dilation Balloon is intended for soft tissue separation and dilation during endoscopic procedures.

    The Tissue Resection Tool is intended for endoscopic resection in the gastrointestinal tract.

    The SuMO™ Snare is intended to remove polyps and small tumors from the gastrointestinal tract.

    Device Description

    The Apollo Endosurgery SuMO Access and Tissue Resection System is a single-use system intended to access, dissect, and resect soft tissue in endoscopic gastrointestinal procedures.

    The system is comprised of five component devices:

    • Injection Needle ●
    • Tunneling Balloon .
    • Dilation Balloon .
    • Tissue Resection Tool .
    • SuMO Snare ●
    AI/ML Overview

    The SuMO Access and Tissue Resection System underwent various testing to ensure it met acceptance criteria for its intended use.

    1. Table of Acceptance Criteria and Reported Device Performance:

    TestAcceptance CriteriaReported Device Performance
    BiocompatibilityNot specifiedCytotoxicity: Met
    Sensitization: Met
    Intracutaneous Toxicity: Met
    Sterilization (ETO)SAL of 10^-6Achieved SAL of 10^-6
    ETO residuals met FDA and international requirementsETO residuals met requirements
    Product TestingNot specifiedDimensional: Met
    Inflation/deflation: Met
    Balloon size and reloading: Met
    Resistivity: Met
    Endoscope compatibility: Met
    Electrical Safety & Electromagnetic CompatibilityRequirements of test standardsMet requirements of test standards

    2. Sample size used for the test set and the data provenance:

    The document does not provide details on the sample size for each specific test or the data provenance (e.g., country of origin, retrospective/prospective). It generally states that "Product testing was completed and met the acceptance criteria."

    3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts:

    This information is not available in the provided document. The studies conducted are related to device performance and safety, not diagnostic accuracy requiring expert ground truth establishment.

    4. Adjudication method for the test set:

    Not applicable. The testing described is performance-based, not involving expert adjudication of results.

    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 is a medical device for tissue access and resection, not an AI or diagnostic tool that would involve human readers or MRMC studies.

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

    Not applicable. This is a medical device, not an algorithm.

    7. The type of ground truth used:

    For biocompatibility, the ground truth would be established by standard biological assays confirming the absence of adverse reactions. For sterilization, the ground truth is a sterility assurance level (SAL) of 10^-6. For product testing (dimensional, inflation/deflation, etc.), the ground truth would be the pre-defined engineering specifications and functional requirements for the device components. Electrical safety and EMC ground truth are defined by relevant international standards.

    8. The sample size for the training set:

    Not applicable. This is not a machine learning or AI device that would require a training set.

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

    Not applicable. As this is not an AI/machine learning device, there is no training set or associated ground truth.

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