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510(k) Data Aggregation

    K Number
    K041795
    Date Cleared
    2004-09-14

    (74 days)

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

    K032889, K963359

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

    The Optical Separator System is a sterile single use device, intended for use in conjunction with Applied's currently marketed Trocar products to establish a path of entry for endoscopic instruments for use during general, abdominal, gynecological and thoracic minimally invasive procedures or to gain access through tissue planes and/or potential spaces for endoscopic instruments. The Optical Separator System may be used with or without visualization for primary and secondary insertions, and as a means of insufflating the peritoneum prior to laparoscopic procedures.

    The Optical Separator System is indicated for use in general, abdominal, gynecological and thoracic minimally invasive surgical procedures to establish a path of entry or to gain access through tissue planes and/or potential spaces for endoscopic instruments, and as a means of insufflating the peritoneum prior to laparoscopic procedures.

    Device Description

    The Optical Separator System is a sterile single use device, intended for use in conjunction with Applied's currently marketed Trocar products. A standard trocar assembly consists of an obturator, a seal and a cannula system. Traditional obturators use a blade for cutting to establish a path of entry through the several layers of tissue. The Dilating Tip Trocar dilates and separates tissue along its natural fiber lines in its path of entry.

    The Optical Separator System will be available in sizes of 5mm, 11mm and 12mm diameter in lengths ranging from 55mm to 150mm.

    AI/ML Overview

    The provided document is a 510(k) summary for the Optical Separator System. It describes the device, its intended use, and states that performance testing demonstrated substantial equivalence to predicate devices. However, the document does not contain specific acceptance criteria or a detailed study description with performance metrics that would allow for a comprehensive table as requested.

    The document states: "The performance and functional testing of the Optical Separator System included tests to verify the insertion force and tests to verify its reliability and visualization during use. The performance and functional testing demonstrated that the Optical Separator System is substantially equivalent to its predicate devices and it introduces no new safety and effectiveness issues when used as instructed." This is a general statement and does not provide quantifiable acceptance criteria or detailed results.

    Therefore, many of the requested fields cannot be filled from the provided text.

    Here’s what information can be extracted/inferred:

    1. Table of acceptance criteria and the reported device performance

    Acceptance CriteriaReported Device Performance
    GeneralSubstantially equivalent to predicate devices (Applied Medical Optical Separator K032889 and Insufflation Needle K963359)
    Insertion ForceTested and verified
    ReliabilityTested and verified
    Visualization during useTested and verified

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

    • Sample Size: Not specified.
    • Data Provenance: Not specified (likely internal company testing, but no details on country or whether it was retrospective/prospective).

    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. This device is a surgical instrument, not an AI/diagnostic tool requiring expert ground truth for image interpretation or diagnosis. The "performance data" refers to functional and reliability testing.

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

    • Not applicable for this type of device and testing.

    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 not an AI/diagnostic device.

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

    • Not applicable. This is a physical surgical instrument.

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

    • Not applicable. Performance testing for this device would involve engineering benchmarks, material specifications, and functional testing rather than clinical ground truth for diagnosis/interpretation.

    8. The sample size for the training set

    • Not applicable. This is a physical surgical instrument, not an AI model requiring a training set.

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

    • Not applicable.
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