SPIDER SURGICAL INSTRUMENTS, FLEXIBLE MONOPOLAR GRASPER WAVY RATCHETED, SPIDER SURGICAL INSTRUMENTS, FLEXIBLE MONOPOLAR

K122299 · Transenterix, Inc. · GCJ · Oct 25, 2012 · Gastroenterology, Urology

Device Facts

Record IDK122299
Device NameSPIDER SURGICAL INSTRUMENTS, FLEXIBLE MONOPOLAR GRASPER WAVY RATCHETED, SPIDER SURGICAL INSTRUMENTS, FLEXIBLE MONOPOLAR
ApplicantTransenterix, Inc.
Product CodeGCJ · Gastroenterology, Urology
Decision DateOct 25, 2012
DecisionSESE
Submission TypeTraditional
Regulation21 CFR 876.1500
Device ClassClass 2
AttributesTherapeutic

Indications for Use

The SPIDER® Surgical Instruments are intended for use in minimally invasive abdominal laparoscopic surgical procedures for grasping, mobilizing, dissecting, cutting, cauterizing, ligating, suction/irrigation and other manipulation of tissues and vessels during laparoscopic procedures.

Device Story

SPIDER® Flexible Monopolar Surgical Instruments are disposable, single-use laparoscopic tools designed for use with the SPIDER® Single Port Device. Instruments include graspers, shears, and dissectors. Features include ring handle with ratchets, rotation knob, flexible shaft, and electrocautery post for connection to electrosurgical generators. Used by surgeons in laparoscopic procedures to manipulate, cut, or coagulate tissue. When connected to a generator, provides monopolar electrosurgical capability. Instruments are passed through instrument delivery tubes (IDTs) to the surgical site. Benefits include facilitating minimally invasive access and tissue management during abdominal surgery.

Clinical Evidence

No human clinical data provided. Evidence consists of bench testing (functionality, reliability, sterility per ISO 11137, packaging per ISO 11607/ASTM F1980, biocompatibility per ISO 10993-1, electrical safety per IEC 60601-1/1-2/2-2) and a preclinical swine study evaluating performance in laparoscopic procedures.

Technological Characteristics

Monopolar electrosurgical instruments; flexible shaft; ring handle with ratchets; disposable/single-use. Materials tested for biocompatibility (ISO 10993-1). Electrical safety compliant with IEC 60601-1, IEC 60601-1-2, and IEC 60601-2-2. Sterilization via Gamma radiation (ISO 11137). Packaging compliant with ISO 11607-1/2 and ASTM F1980-07.

Indications for Use

Indicated for patients undergoing minimally invasive abdominal laparoscopic surgical procedures requiring tissue/vessel manipulation, including grasping, mobilizing, dissecting, cutting, cauterizing, ligating, and suction/irrigation.

Regulatory Classification

Identification

An endoscope and accessories is a device used to provide access, illumination, and allow observation or manipulation of body cavities, hollow organs, and canals. The device consists of various rigid or flexible instruments that are inserted into body spaces and may include an optical system for conveying an image to the user's eye and their accessories may assist in gaining access or increase the versatility and augment the capabilities of the devices. Examples of devices that are within this generic type of device include cleaning accessories for endoscopes, photographic accessories for endoscopes, nonpowered anoscopes, binolcular attachments for endoscopes, pocket battery boxes, flexible or rigid choledochoscopes, colonoscopes, diagnostic cystoscopes, cystourethroscopes, enteroscopes, esophagogastroduodenoscopes, rigid esophagoscopes, fiberoptic illuminators for endoscopes, incandescent endoscope lamps, biliary pancreatoscopes, proctoscopes, resectoscopes, nephroscopes, sigmoidoscopes, ureteroscopes, urethroscopes, endomagnetic retrievers, cytology brushes for endoscopes, and lubricating jelly for transurethral surgical instruments. This section does not apply to endoscopes that have specialized uses in other medical specialty areas and that are covered by classification regulations in other parts of the device classification regulations.

Special Controls

*Classification* —(1)*Class II (special controls).* The device, when it is an endoscope disinfectant basin, which consists solely of a container that holds disinfectant and endoscopes and accessories; an endoscopic magnetic retriever intended for single use; sterile scissors for cystoscope intended for single use; a disposable, non-powered endoscopic grasping/cutting instrument intended for single use; a diagnostic incandescent light source; a fiberoptic photographic light source; a routine fiberoptic light source; an endoscopic sponge carrier; a xenon arc endoscope light source; an endoscope transformer; an LED light source; or a gastroenterology-urology endoscopic guidewire, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 876.9.(2) Class I for the photographic accessories for endoscope, miscellaneous bulb adapter for endoscope, binocular attachment for endoscope, eyepiece attachment for prescription lens, teaching attachment, inflation bulb, measuring device for panendoscope, photographic equipment for physiologic function monitor, special lens instrument for endoscope, smoke removal tube, rechargeable battery box, pocket battery box, bite block for endoscope, and cleaning brush for endoscope. The devices subject to this paragraph (b)(2) are exempt from the premarket notification procedures in subpart E of part 807of this chapter, subject to the limitations in § 876.9.

In combination with the general controls of the FD&C Act, the integrated operating table-electromechanical surgical system is subject to the following special controls: 1. (1) Premarket clinical performance testing, or a combination of premarket clinical performance testing and postmarket surveillance (in accordance with special control (2)), must include the following: 1. (i) Objective performance measures (e.g., rate and number of conversions to other surgical modalities, rate of device related adverse events (including tissue injury, hematoma, and increased blood loss), and their severity, cause, and outcomes) must be reported with relevant descriptive comparator performance measures. 2. (ii) The data must demonstrate the performance of the device for providing accurate and precise control of attached surgical instruments in range of clinical conditions relevant to the device's intended use. 3. (iii) The test dataset must include data collected from a patient population representative of the intended patient population under anticipated conditions of use. 2. (2) Data obtained from postmarket surveillance must demonstrate, in consideration of the premarket data obtained in accordance with special control (1), that the device performs in accordance with special control (1), unless FDA determines, based on the totality of the premarket data, that data from postmarket surveillance is not required to demonstrate that the device performs as intended. Such postmarket surveillance must be conducted per a protocol determined appropriate by FDA to demonstrate that the device performs as intended (in consideration of the premarket data obtained in accordance with special control (1)), and must include initiation, enrollment, and reporting requirements to ensure timely periodic updates to FDA on post-market surveillance progress and outcomes. 3. (3) Animal performance testing must evaluate the extent of port site trauma due to repositioning of table during surgical procedures when utilizing robotic minimally invasive and laparoscopic approaches 4. (4) The device manufacturer must develop, and update as necessary, a device-specific use training program that ensures proper device setup/use/shutdown, accurate control of instruments to perform the intended surgical procedures, troubleshooting and handling during unexpected events or emergencies, and safe practices to mitigate use error. 5. (5) The device manufacturer may only distribute the device to facilities that implement and maintain the device-specific use training program and ensure that users of the device have completed the device-specific use training program. (6) Human factors assessment must demonstrate that the user can correctly use the device system across all intended use environments with the provided instructions and training materials, including patient access during normal operating conditions and emergency situations, and effects arising from the integrated nature of the operating table and robotic surgical arms. (7) Labeling must include: (i) A detailed summary of clinical performance testing conducted with the device, including study population, results, adverse events, and comparisons to any comparator groups identified; (ii) A statement in the labeling that the safety and effectiveness for the representative specific procedures was based on evaluation of the device as a surgical tool and did not include evaluation of outcomes related to the treatment of the patient's underlying disease or condition, unless FDA determines that it can be removed or modified based on clinical performance data submitted to FDA; (iii) Identification of compatible devices; (iv) The list of surgical procedures for which the device has been determined to be safe with clinical justification; (v) Reprocessing instructions for reusable components; (vi) A shelf life for any sterile components; (vii) A description of the device-specific use training program; (viii) A statement that the device is only for distribution to facilities that implement and maintain the device-specific use training program and ensure that users of the device have completed the device-specific use training program; and (ix) A summary of any completed postmarket surveillance data collected as required by special control (2), including updated labeling to accurately reflect outcomes observed in postmarket surveillance. (8) Non-clinical performance testing must demonstrate that the device performs as intended under anticipated conditions of use and must include: (i) Device motion accuracy and repeatability; (ii) System testing; (iii) Instrument reliability; (iv) Crosstalk; (v) Table motion control; (vi) Thermal effects on tissue; (vii) User-device interface performance; (viii) Workspace access testing; and (ix) Performance testing with compatible devices. (9) Software verification, validation, and hazard analysis must be performed. (10) Electromagnetic compatibility and electrical, thermal, and mechanical safety testing must be performed. (11) Performance data must demonstrate the sterility of all patient-contacting device components. (12) Performance data must support the shelf life of the device components provided sterile by demonstrating continued sterility and package integrity over the labeled shelf life. (13) Performance data must validate the reprocessing instructions for the reusable components of the device. (14) Performance data must demonstrate that all patient-contacting components of the device are biocompatible. (15) Performance data must demonstrate that all patient-contacting components of the device are non-pyrogenic. (16) The device manufacturer must submit a report to the FDA annually on the anniversary of initial marketing authorization for the device, until such time as FDA may terminate such reporting, which comprises the following information: (i) Cumulative summary, by year, of complaints and adverse events since date of initial marketing authorization; and (ii) Identification and rationale for changes made to the device, labeling, or device specific use training program, which did not require submission of a premarket notification during the reporting period.

Predicate Devices

Submission Summary (Full Text)

{0}------------------------------------------------ Image /page/0/Picture/0 description: The image shows the logo for TransEnterix, a medical technology company. The logo features a stylized letter "T" with a horizontal line above it, followed by the word "ransEnterix" in a modern sans-serif font. Below the company name is the tagline "advancing surgery through innovation" in a smaller font, with trademark symbols next to both the company name and the tagline. OCT 2 5 2012 ## K122299 - 510(k) Summary This summary of safety and effectiveness information is being submitted in accordance with requirements of 21 CFR Part 807.92. Date: July 27, 2012 | 1. | Submitter: | | | | |----|----------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--|--| | | Submitted by: | TransEnterix, Inc.<br>635 Davis Drive, Suite 300<br>Durham, NC 27713<br>TEL: 919-765-8420<br>FAX: 919-765-8459 | | | | | Contact: | Tammy Carrea<br>VP Quality and Regulatory Affairs | | | | 2. | Device: | | | | | | Propriety Name | SPIDER® Flexible Surgical Instruments:<br>Flex Monopolar Graspers, Wavy Ratcheted<br>Flex Monopolar Graspers, Serrated Ratcheted<br>Flex Monopolar Maryland Dissectors<br>Flex Monopolar Shears | | | | | Common Name | Electrosurgical Monopolar Surgical Instrument | | | | | Classification Name: | Electrosurgical cutting and coagulation device and<br>accessories | | | | | Classification: | Class II, 21 CFR 878.4400 | | | | | Product Code: | GEI | | | | | | | | | ## 3. Predicate Devices: | Class | Manufacturer | 510(k) Number | Device Name/Description | |-------|--------------|--------------------|------------------------------------------------------------------------------------| | II | TransEnterix | K091697<br>K102646 | SPIDER® Flexible Instruments: Maryland<br>Dissector, Graspers (Blunt nose), Shears | | II | Covidien | K091869 | SILS™ Clincher, Graspers, Dissector,<br>Shears | ## 4. Description: The SPIDER® Flexible Monopolar Instruments are surgical instruments used to facilitate laparoscopic surgery. The instruments are a part of the SPIDER® Flexible Surgical {1}------------------------------------------------ Instruments family. They are intended for use with the SPIDER® Single Port Device. The instruments may be used with or without electrocautery. The flexible electrocautery instruments are pre-sterilized, single use, disposable devices. The devices have a ring handle with ratchets where applicable, a rotation knob for rotating the shaft and distal tips, an electrocautery post for cable connection to an electrosurgical generator, a flexible shaft, and distal tips to manipulate tissue. The instruments may be used without connecting to a power source. However, when connected by a standard cable to an electrosurgical generator, the instruments may be used for cutting and coagulation of tissue. The instrument set includes: - . Flexible graspers for grasping tissue - Flexible shears for cutting tissue . - Flexible dissectors for dissecting tissue . #### 5. Indications for Use: The SPIDER® Surgical Instruments are intended for use in minimally invasive abdominal laparoscopic surgical procedures for grasping, mobilizing, dissecting, cutting, cauterizing, ligating, suction/irrigation and other manipulation of tissues and vessels during laparoscopic procedures. ### 6. Comparison of Technological Characteristics with Predicate: The SPIDER® Flexible Monopolar Surgical Instruments have the same intended use and function of other currently marketed laparoscopic and endoscopic surgical instruments, specifically the SPIDER® Surgical Instruments cleared in K091697. Like the predicates the instruments have the same or similar end effector/jaw/tip designs. The devices achieve the same function using the same modes of action. The flexible instruments are passed through the SPIDER®'s instrument delivery tubes (IDTs) and advanced to the surgical site in exactly in the same manner as other previously cleared SPIDER® surqical instruments. The SPIDER® Flexible Monopolar Instruments utilize the same or similar design. dimensions, materials of construction, packaging and sterilization as that of the SPIDER® Surgical Instruments in K091697. Similar to the predicate devices the SPIDER® Flexible Monopolar Instruments are provided pre-sterilized, are disposable, and are single use devices. The electrocautery features of the SPIDER® Flexible Monopolar Surgical Instruments are similar to those of the SILS™ Dissector and Shears from K091869. Both device designs are monopolar and include a post for cable connection to an electrosurgical generator. Both device designs are utilized with single port laparoscopic access systems. Any technological differences between the SPIDER® Flexible Monopolar Surgical Instruments and the predicates have been mitigated via testing. The SPIDER® Flexible Monopolar Surgical Instruments do not introduce any new issues of safety or effectiveness compared to other similar laparoscopic surgical devices currently marketed. {2}------------------------------------------------ ## 7. Performance Data: The SPIDER® Flexible Monopolar Surgical Instruments have been functionally tested and found to perform their intended functions for laparoscopic surgical procedures as well as their electrocautery functions and have been tested for reliability. The devices have also been tested with the SPIDER® device and found to meet the internal acceptance criteria for system compatibility with the SPIDER® platform. Gamma sterility testing has been conducted for the SPIDER® Flexible Instruments Family which includes the SPIDER® Flexible Monopolar Instruments and has been shown to achieve a sterility assurance level of 1x10 . The devices were verified as sterile via a dose audit study in accordance with ISO 11137-1, ISO 11137-2, and ISO 11137-3. In addition, the sterile barrier packaging has been tested for the SPIDER® Flexible Instruments family in accordance with ISO 11607-1 and 11607-2 and ASTM F1980-07 and has been found to maintain sterility during shelf life testing. The SPIDER® Flexible Monopolar Instruments have likewise been tested for functionality over time and have been found to maintain performance in accordance with the design specifications. The SPIDER® Instruments have been tested for biocompatibility in accordance with ISO 10993-1 based on type and duration of contact to assure that they are non-cytoxic, nonirritating and non-sensitizing. The SPIDER® Flexible Monopolar Instruments have been evaluated and/or tested for compliance to the medical electrical safety standards IEC 60601-1, IEC 60601-1-2, and IEC 60601-2-2 and found to be compliant. The device insulation has also been tested using high potential test (HIPOT) and dielectric withstand testing to assure that the insulation maintains its properties and does not breakdown. The SPIDER® Flexible Monopolar Surgical Instruments have been tested in a preclinical swine study to evaluate their performance and success in laparoscopic procedures. The study found that the SPIDER® Flexible Monopolar Instruments performed as intended. When compared to the predicate devices, the SPIDER® Flexible Monopolar Instruments do not incorporate any significant technological differences that affect safety and efficacy, therefore, clinical data was not deemed necessary for evaluation of substantial equivalence. These verification and validation test results are sufficient to demonstrate safety and effectiveness compared to predicate devices used in standard laparoscopic surgical techniques. Any minor technological differences in the design or materials of the SPIDER® Surgical Instruments have been evaluated and found to present no new issues of safety and effectiveness. #### Conclusion: 8. The conclusion drawn from the test data is that the SPIDER® Flexible Monopolar Surgical Instruments are as safe and effective as the predicate devices, have the same intended use as the predicates, perform similarly to other legally marketed predicate devices for laparoscopic surgery, and do not raise any new issues of safety or effectiveness. {3}------------------------------------------------ Image /page/3/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" around the perimeter. Inside the circle is an abstract image of an eagle. #### DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002 Transenterix, Incorporated % Ms. Tammy B. Carrea Vice President, Quality and Regulatory Affairs 635 Davis Drive, Suite 300 Durham, North Carolina 27713 OCT 25 2012 Re: K12299 Trade/Device Name: SPIDER®(Single Port Instrument Delivery Extended Reach) Surgical Instruments Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical cutting and coagulation device and accessories Regulatory Class: Class II Product Code: GEI Dated: July 27, 2012 · Received: July 31, 2012 Dear Ms. Carrea: We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading. If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical {4}------------------------------------------------ ### Page 2 - Ms. Tammy B. Carrea device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050. If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance. You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. Sincerely yours, Mark N. Melkerson Director Division of Surgical, Orthopedic and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health Enclosure {5}------------------------------------------------ K122299 510(k) No. If known # Indications For Use Statement Device Name: SPIDER® (Single Port Instrument Delivery Extended Reach) Surgica! Instruments Indications For Use: The SPIDER® Surgical Instruments are intended for use in minimally invasive abdominal laparoscopic surgical procedures for grasping, mobilizing, dissecting, cutting, cauterizing, ligating, suction/irrigation and other manipulation of tissues and vessels during laparoscopic procedures. Neil R. P. Ogden for nxm Division Sign-Off) Division of Surgical, Orthopedic, and Restorative Devices | 510(k) Number | K122299 | | | |----------------------------|---------|--------|----------------------------| | Prescription Use | x | AND/OR | Over-The-Counter Use | | (Per 21 CFR 801 Subpart D) | | | (Per 21 CFR 801 Subpart C) | (PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NECESSARY) Concurrence of CDRH, Office of Device Evaluation (ODE) (Division Sign-Off) Division of Surgical, Orthopedic, and Restorative Devices | 510(k) Number | 1122259 | |---------------|---------| |---------------|---------|
Innolitics

Panel 1

/
Ready

Predicate graph will load when search results are available.

Embedding visualization will load when search results are available.

PDF viewer will load when search results are available.

Loading panels...

Select an item from Submissions

Click any panel, subpart, regulation, product code, or device to see details here.

Section Matches

Results will appear here.

Product Code Matches

Results will appear here.

Special Control Matches

Results will appear here.

Loading collections...