ADEPT 1064/532/755 LASER

K032218 · Adept Medical Concepts · GEX · Oct 24, 2003 · General, Plastic Surgery

Device Facts

• Record ID: K032218
• Device Name: ADEPT 1064/532/755 LASER
• Applicant: Adept Medical Concepts
• Product Code: GEX · General, Plastic Surgery
• Decision Date: Oct 24, 2003
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 878.4810
• Device Class: Class 2
• Attributes: Therapeutic

Indications for Use

The Adept 1064/532/755 Laser is indicated for coagulation and hemostasis of vascular lesions and removal and permanent reduction of unwanted hair in Fitzpatrick skin types I - VI, including suntanned skin types. Permanent hair reduction is defined as a long-term stable reduction in the number of hairs regrowing after a treatment regimen. The Adept 1064/532/755 Laser is intended: 755 nm wavelength For the coagulation and hemostasis of vascular lesions and the removal and permanent reduction of unwanted hair in Fitzpatrick skin types I - VI, including suntanned skin types. 1064 nm wavelength General Surgical Applications: For the incision, excision, coagulation, hemostasis, vaporization, and/or ablation of soft tissue in dermatology/plastic surgery, endoscopic/laparoscopic general surgery, gastroenterology, general surgery, gynecology, head and neck/otorhinolaryngology (ENT), neurosurgery, oculoplastics, orthopedics, pulmonary surgery, thoracic surgery, and urology. Dermatology/Plastic Surgery: For photocoagulation and hemostasis of benign vascular lesions such as, but not limited to, port wine stains, hemangiomas, warts, telangiectasia, rosacea, venus lake, leg and spider veins. In addition, the 1064/532/755 Laser is intended for the treatment of benign, pigmented lesions such as, but not limited to, lentigos (age spots), solar lentigos (sun spots). café au lait macules, seborrheic keratoses, nevi, chloasma, verrucae, skin tags, keratoses, tattoos (significant reduction in the intensity of blue and/or black tattoos) and plaques. The 1064/532/755 Laser is also indicated for pigmented lesions to reduce lesion size, for patients with lesions that would potentially benefit from aggressive treatment, and for patients with lesions that have not responded to other laser treatments. Cutting, incision, excision, hemostasis, coagulation, vaporization, and ablation of soft tissue in dermatology and plastic surgery. For the treatment of facial wrinkles and wrinkles such as, but not limited to, periocular and periorbital wrinkles. For the removal of unwanted hair, for the stable long tem, or permanent, hair reduction through selective targeting of melanin in hair follicles, and for the treatment for pseudofolliculitis barbae (PFB). For the reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral part of the scar. For the removal and permanent reduction of unwanted hair in Fitzpatrick skin types I - VI, including suntanned skin types. Endoscopic/Laparoscopic Surgery: For use in a variety of surgical procedures in several surgical specialties. These include, but are not limited to, cholecystectomy, appendectomy, vagotomy, and pyloromyomotomy where its abilities to incise, excise, coagulate, vaporize, or ablate soft tissue may be applied. General Surgery: For incision, excision, vaporization, ablation, and hemostasis of soft tissue general surgery applications, skin incisions, tissue dissection, excision of external turnors and lesions, complete or partial resection of internal organs, tumors, lesions, tissue ablation, vessel coagulation, tonsillectomy, and hemorrhoids. Gynecology: For the treatment of menorrhagia by photocoagulation of the endometrial lining of the uterus, ablation of endometrial implants and/or peritoneal adhesions, soft tissue excisional procedures such as excisional conization of the cervix, intrauterine gynecologic procedures where cutting, ablation, and/or vessel coagulation may be indicated including submucous fibroids, benign endometrial polyps, and uterine septum. Head and Neck/Otorhinolaryngology (ENT): For tissue incision, excision, ablation, and vessel hemostasis. Hemostasis During Surgery: For adjunctive coagulation and hemostasis (bleeding control) during surgery in endoscopic (e.g. laparoscopic) and open procedures. Neurosurgery: For hemostasis for pituitary tumor, meningioma, hemagioblastoma, AVMs. glioblastoma, astrocytoma, oligodendroglioma. Oculoplastics: For incision, excision, vaporization, and/or coagulation of tissues in oculoplastic procedures such as operations on the lacrimal system, operation on the eyelids, removal of biopsy or orbital tumors, enucleation on eyeball, exteneration of orbital contents. Pulmonary Surgery: For palliative treatment of benign and malignant pulmonary airway obstructions, including squamous cell carcinoma, adenocarcinoma, carcinoid, benign tumors, granulomas, and benign strictures. Thoracic Surgery: For cutting (incision/excision), coagulating, and vaporization of soft tissue. Thoracic applications, including but not limited to, isolation of vessels for endarterectomy and/or by-pass grafts, wedge resections, thoractomy, formation of pacemaker pockets; vaporization, coagulation, incision, debulking, and ablation of lung tissue (thoracoscopy). Urology: For all applications including superficial urinary bladder tumors, invasive bladder carcinoma, urethral strictures and lesions of the external genitalia (including condyloma acuminata). Orthopedics: For cutting, ablation, and/or hemostasis of intra-articular tissue in orthopedic surgical and arthroscopic applications. 532 nm wavelength For the coagulation and hemostasis of vascular lesions. Dermatology/Plastic Surgery: For photocoagulation and hemostasis of vascular and cutaneous lesions in dermatology including, but not limited to, the following general categories: vascular lesions [angiomas, hemangiomas (port wine), telangiectasia (facial or extremities telangiectasias, venous anomalies, leg veins]: benign pigmented lesions (nevi, lentigines, chloasma, café au- lait, tattoos (red and green ink), verrucae, skin tags, keratoses, plaques, cutaneous lesion treatment (hemostasis, color lightening, blanching, flattening, reduction of lesion size.

Device Story

Multi-wavelength surgical laser system; combines long-pulse Nd:YAG (1064 nm), KTP-converted (532 nm), and alexandrite (755 nm) lasers. Used by physicians in clinical, surgical, and endoscopic settings for soft tissue management (incision, excision, ablation, hemostasis) and dermatological procedures (vascular/pigmented lesion treatment, hair reduction). Device delivers laser energy to target tissues; thermal effects achieve coagulation, vaporization, or ablation. Healthcare providers operate device to treat specific pathologies; output allows for precise tissue interaction, reducing bleeding and enabling minimally invasive surgical access. Benefits include improved hemostasis, lesion removal, and permanent hair reduction.

Clinical Evidence

No clinical data required; substantial equivalence based on bench testing and comparison of specifications/characteristics to predicate devices.

Technological Characteristics

Multi-wavelength laser system (1064 nm Nd:YAG, 532 nm KTP, 755 nm alexandrite). Laser surgical instrument (21 CFR 878.4810). Class II device. Energy source: laser. Form factor: surgical laser system.

Indications for Use

Indicated for coagulation/hemostasis of vascular lesions and permanent hair reduction in Fitzpatrick skin types I-VI (including suntanned skin). Also indicated for soft tissue incision, excision, ablation, vaporization, and hemostasis across multiple surgical specialties including dermatology, plastic surgery, ENT, gynecology, neurosurgery, urology, orthopedics, and thoracic surgery.

Regulatory Classification

Identification

(1) A carbon dioxide laser for use in general surgery and in dermatology is a laser device intended to cut, destroy, or remove tissue by light energy emitted by carbon dioxide.(2) An argon laser for use in dermatology is a laser device intended to destroy or coagulate tissue by light energy emitted by argon.

Predicate Devices

• Depilase Twin LASE Laser (K020412)
• Depilase Twin YAG Laser (K020697)
• Cynosure Apogee-TKS Laser (K992757)
• Candela GentleLASE GL (K994260)
• Candela GentleLASE II (K984601)
• Altus Family CoolGlide Aesthetic Lasers (K014040, K003202, K023954, K022226, K981798)
• Lyra Series Surgical Laser System (K990903, K003765, K003147, K010284, K010834, K020021)

Submission Summary (Full Text)

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K 032218 1/6

#### SECTION 9

#### 510(k) SUMMARY

This 510(k) summary of safety and effectiveness for the Adept 1064/532/755 Laser is submitted in accordance with the requirements of SMDA 1990 and follows Office of Device Evaluation guidance concerning the organization and content of a 510(k) summary.

- Applicant: Adept Medical Concepts, Inc.
- 29816 Avenue De Las Banderas Address: Rancho Santa Margarita, CA 92688
- Contact person: Mr. Jerry McFarland President jmcfarland(@adeptmedicalconcepts.com
- 949-635-9238 Telephone: [phone] (fax)

Preparation Date: July 2003 (of the Summary)

- Adept 1064/532/755 Laser Device Name:
Surgical laser Common Name:

- Classification: Laser surgical instrument for use in general and plastic surgery and dermatology
Class II medical device; (21 CFR 878.4810).

Product Code: GEX Panel: 79

- The Depilase Twin LASE Laser (K020412) and Depilase Twin YAG Laser Predicate devices: Cynosure Apogee-TKS Laser (K992757); (K020697); Candela GentleLASE GL (K994260) and GentleLASE II (K984601); Altus Family CoolGlide Aesthetic Lasers (K014040, K003202, K023954, K022226, K981798); and the Lyra Series Surgical Laser System (K990903, K003765, K003147, K010284, K010834, K020021).
- Device description: The Adept 1064/532/755 Laser combines a long pulse Nd: Y AG laser which emits energies at 1064 nm with a KTP crystal which converts the 1064 nm laser to 532 nm and an alexandrite laser which emits energy at 755 nm.

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KO32218

Image /page/1/Picture/1 description: The image shows a fraction. The numerator is 2 and the denominator is 6. The fraction is written in a simple, handwritten style. The numbers are clear and easy to read.

- Indications: The Adept 1064/532/755 Laser is indicated for coagulation and hemostasis of vascular lesions and removal and permanent reduction of unwanted hair in Fitzpatrick skin types I - VI, including suntanned skin types. Permanent hair reduction is defined as a long-term stable reduction in the number of hairs regrowing after a treatment regimen.
The Adept 1064/532/755 Laser is intended:

### 755 nm wavelength

For the coagulation and hemostasis of vascular lesions and the removal and permanent reduction of unwanted hair in Fitzpatrick skin types I - VI, including suntanned skin types.

### 1064 nm wavelength

### General Surgical Applications:

For the incision, excision, coagulation, hemostasis, vaporization, and/or ablation of soft tissue in dermatology/plastic surgery, endoscopic/laparoscopic general surgery, gastroenterology, general surgery, gynecology, head and neck/otorhinolaryngology (ENT), neurosurgery, oculoplastics, orthopedics, pulmonary surgery, thoracic surgery, and urology.

### Dermatology/Plastic Surgery:

For photocoagulation and hemostasis of benign vascular lesions such as, but not limited to, port wine stains, hemangiomas, warts, telangiectasia, rosacea, venus lake, leg and spider veins. In addition, the 1064/532/755 Laser is intended for the treatment of benign, pigmented lesions such as, but not limited to, lentigos (age spots), solar lentigos (sun spots). café au lait macules, seborrheic keratoses, nevi, chloasma, verrucae, skin tags, keratoses, tattoos (significant reduction in the intensity of blue and/or black tattoos) and plaques.

The 1064/532/755 Laser is also indicated for pigmented lesions to reduce lesion size, for patients with lesions that would potentially benefit from aggressive treatment, and for patients with lesions that have not responded to other laser treatments. Cutting, incision, excision, hemostasis, coagulation, vaporization, and ablation of soft tissue in dermatology and plastic surgery.

For the treatment of facial wrinkles and wrinkles such as, but not limited to, periocular and periorbital wrinkles.

For the removal of unwanted hair, for the stable long tem, or permanent, hair reduction through selective targeting of melanin in hair follicles, and for the treatment for pseudofolliculitis barbae (PFB).

{2}------------------------------------------------

For the reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral part of the scar.

For the removal and permanent reduction of unwanted hair in Fitzpatrick skin types I - VI, including suntanned skin types.

## Endoscopic/Laparoscopic Surgery:

For use in a variety of surgical procedures in several surgical specialties. These include, but are not limited to, cholecystectomy, appendectomy, vagotomy, and pyloromyomotomy where its abilities to incise, excise, coagulate, vaporize, or ablate soft tissue may be applied.

## General Surgery:

For incision, excision, vaporization, ablation, and hemostasis of soft tissue general surgery applications, skin incisions, tissue dissection, excision of external turnors and lesions, complete or partial resection of internal organs, tumors, lesions, tissue ablation, vessel coagulation, tonsillectomy, and hemorrhoids.

## Gynecology:

For the treatment of menorrhagia by photocoagulation of the endometrial lining of the uterus, ablation of endometrial implants and/or peritoneal adhesions, soft tissue excisional procedures such as excisional conization of the cervix, intrauterine gynecologic procedures where cutting, ablation, and/or vessel coagulation may be indicated including submucous fibroids, benign endometrial polyps, and uterine septum.

### Head and Neck/Otorhinolaryngology (ENT):

For tissue incision, excision, ablation, and vessel hemostasis.

### Hemostasis During Surgery:

For adjunctive coagulation and hemostasis (bleeding control) during surgery in endoscopic (e.g. laparoscopic) and open procedures.

### Neurosurgery:

For hemostasis for pituitary tumor, meningioma, hemagioblastoma, AVMs. glioblastoma, astrocytoma, oligodendroglioma.

{3}------------------------------------------------

# Oculoplastics:

For incision, excision, vaporization, and/or coagulation of tissues in oculoplastic procedures such as operations on the lacrimal system, operation on the eyelids, removal of biopsy or orbital tumors, enucleation on eyeball, exteneration of orbital contents.

# Pulmonary Surgery:

For palliative treatment of benign and malignant pulmonary airway obstructions, including squamous cell carcinoma, adenocarcinoma, carcinoid, benign tumors, granulomas, and benign strictures.

# Thoracic Surgery:

For cutting (incision/excision), coagulating, and vaporization of soft tissue. Thoracic applications, including but not limited to, isolation of vessels for endarterectomy and/or by-pass grafts, wedge resections, thoractomy, formation of pacemaker pockets; vaporization, coagulation, incision, debulking, and ablation of lung tissue (thoracoscopy).

# Urology:

For all applications including superficial urinary bladder tumors, invasive bladder carcinoma, urethral strictures and lesions of the external genitalia (including condyloma acuminata).

# Orthopedics:

For cutting, ablation, and/or hemostasis of intra-articular tissue in orthopedic surgical and arthroscopic applications.

# 532 nm wavelength

For the coagulation and hemostasis of vascular lesions.

# Dermatology/Plastic Surgery:

For photocoagulation and hemostasis of vascular and cutaneous lesions in dermatology including, but not limited to, the following general categories: vascular lesions [angiomas, hemangiomas (port wine), telangiectasia (facial or extremities telangiectasias, venous anomalies, leg veins]: benign pigmented lesions (nevi, lentigines, chloasma, café au- lait, tattoos (red and green ink), verrucae, skin tags, keratoses, plaques, cutaneous lesion treatment (hemostasis, color lightening, blanching, flattening, reduction of lesion size.

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Image /page/4/Picture/0 description: The image shows handwritten text on a white background. The text "KO32218" is written on the top line, and "5/6" is written on the bottom line. The numbers and letters are written in a simple, clear font.

## General Surgery:

Vaporizing, Coagulating, Incising, Excising, Debulking, and Ablating of Soft Tissue as well as in Endoscopic (e.g., laparoscopic) or open surgeries.

### Gastroenterology:

Tissue ablation and hemostasis in the gastrointestinal tract; Esophageal neoplastic obstructions, including squamous cell carcinoma and adenocarcinoma; Gastrointestinal hemostasis (including Varices, Esophageal Ulcer, Mallory-Weiss tear, Gastric Ulcer, Angiodysplasia, Stomal Ulcers, Non-bleeding Ulcers, Gastric Erosions); Gastrointestinal Tissue ablation (Benign and Malignant neoplasm, Angiodysplasia, Polyps, Ulcer, Colitis, Hemorrhoids).

## Head and Neck/Otorhinolaryngology (ENT):

Tissue incision, excision, ablation, and vessel hemostasis.

### Hemostasis during Surgery:

Adjunctive coagulation and hemostasis (bleeding control) during surgery in endoscopic (e.g., laparoscopic) and open surgery.

### Neurosurgery:

Hemostasis for: Pituitary Tumor, Meningioma; hemagioblastoma; AVMs; Glioma; Glioblastoma; Astrocytoma; Oligodendroglioma.

### Ophthalmology:

Post-vitrectomy endophotocoagulation of the retina.

### Pulmonary Surgery:

Palliative treatment of benign and malignant pulmonary airway obstructions, including Squamous Cell Carcinoma, Adenocarcinoma, Carcinoid; Benign Tumors; Granulomas; Benign Strictures.

### Thoracic Surgery:

Cutting (incision/excision), coagulating, and vaporizing of soft tissue. Thoracic applications including, but not limited to: Isolation of vessels for endartecetomy and/or by-pass grafts. Wedge Resections, Thoractomy, Formation of Pacemaker pockets. Vaporization, coagulation, incision/excision, debulking, and ablation of lung tissue (Thoracoscopy).

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Image /page/5/Picture/0 description: The image shows handwritten text on a white background. The text "K032218" is on the top line, and "6/6" is on the bottom line. The handwriting is in black ink and appears to be cursive.

# Urology:

All applications including: Superficial urinary bladder tumors, invasive bladder carcinoma; Urethral Strictures; Lesions of the external genitalia (including condyloma acuminata).

- Performance Data: None required. The claim of substantial equivalence is based on comparisons of specifications/characteristics and intended uses of the claimed predicate.
- Conclusion: Based on the information in the notification Adept Medical Concepts, Inc., believes that the Adept 1064/532/755 Laser is substantially equivalent to the claimed predicate(s) - see listing above.

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Image /page/6/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a stylized eagle with three stripes forming its wing and tail feathers. The eagle faces left and is enclosed in a circle with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter.

#### Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

OCT 2 4 2003

Mr. Jerry McFarland President Adept Medical Concepts, Inc. 29816 Avenue De Las Banderas Rancho Santa Margarita, California 92688

Re: K032218

Trade/Device Name: Adept 1064/532/755 Laser Regulation Number: 21 CFR 878.4810 Regulation Name: Laser surgical instrument for use in general and plastic surgery and in dermatology

Regulatory Class: II Product Code: GEX Dated: July 17, 2003 Received: August 4, 2003

Dear Mr. McFarland:

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.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such 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 docs 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); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act): 21 CFR 1000-1050.

{7}------------------------------------------------

Page 2 - Mr. Jerry McFarland

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus. permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at [phone]. Also, please note the regulation entitled. "Misbranding by reference to premarket notification" (21CFR Part 807.97). 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 [phone] or [phone] or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours.

Miriam C. Provost

Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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#### SECTION 7

#### INDICATIONS FOR USE STATEMENT

| 510(k) Number (if known): | K032218 |
|---------------------------|---------|
|---------------------------|---------|

Device Name: Adept 1064/532/755 Laser

Indications for Use Statement:

The Adept 1064/532/755 Laser is indicated for coagulation and hemostasis of vascular lesions and removal and permanent reduction of unwanted hair in Fitzpatrick skin types I - VI, including suntanned skin types. Permanent hair reduction is defined as a long-term stable reduction in the number of hairs regrowing after a treatment regimen.

#### 755 nm wavelength

For the coagulation and hemostasis of vascular lesions and the removal and permanent reduction of unwanted hair in Fitzpatrick skin types I - VI, including suntanned skin types.

#### 1064 nm wavelength

#### General Surgical Applications:

For the incision, excision, coagulation, hemostasis, vaporization, and/or ablation of soft tissue in dermatology/plastic surgery, endoscopic/laparoscopic general surgery, gastroenterology, general surgery, gynecology, head and neck/otorhinolaryngology (ENT), neurosurgery, oculoplastics, orthopedics, pulmonary surgery, thoracic surgery, and urology.

#### Dermatology/Plastic Surgery:

For photocoagulation and hemostasis of benign vascular lesions such as, but not limited to, port wine stains, hemangiomas, warts, telangiectasia, rosacea, venus lake, leg and spider In addition, the 1064/532/755 Laser is intended for the treatment of benign, veins. pigmented lesions such as, but not limited to, lentigos (age spots), solar lentigos (sun spots). café au lait macules, seborrheic keratoses, nevi, chloasma, verrucae, skin tags, keratoses, tattoos (significant reduction in the intensity of blue and/or black tattoos) and plaques.

### (PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation

Prescription Use (Per 21 CFR 801.109)

OR Over-T
miriam C. Provost
(Review Sign Off)

(Division Sign-Off) Division of General, Restorative and Neurological Devices

Over-The Counter Use ________________________________________________________________________________________________________________________________________________________

066

510(k) Number K032218

{9}------------------------------------------------

The 1064/532/755 Laser is also indicated for pigmented lesions to reduce lesion size, for patients with lesions that would potentially benefit from aggressive treatment, and for patients with lesions that have not responded to other laser treatments.

Cutting, incision, excision, hemostasis, coagulation, vaporization, and ablation of soft tissue in dermatology and plastic surgery.

For the treatment of facial wrinkles and wrinkles such as, but not limited to, periocular and periorbital wrinkles.

For the removal of unwanted hair, for the stable long tem, or permanent, hair reduction through selective targeting of melanin in hair follicles, and for the treatment for pseudofolliculitis barbae (PFB).

For the reduction of red pigmentation in hypertrophic and keloid scars where vascularity is an integral part of the scar.

For use on all skin types (Fitzpatrick I - IV) including tanned skin. and the removal and permanent reduction of unwanted hair in Fitzpatrick skin types I - VI, including suntanned skin types (1064 nm wavelength).

#### Endoscopic/Laparoscopic Surgery:

For use in a variety of surgical procedures in several surgical specialties. These include, but are not limited to, cholecystectomy, appendectomy, and pyloromyomotomy where its abilities to incise, excise, coagulate, vaporize, or ablate soft tissue may be applied.

#### General Surgery:

For incision, excision, vaporization, ablation, and hemostasis of soft tissue general surgery applications, skin incisions, tissue dissection, excision of external tumors and lesions, complete or partial resection of internal organs, tumors, lesions, tissue ablation, vessel coagulation, tonsillectomy, and hemorrhoids.

#### Gynecology:

For the treatment of menorrhagia by photocoagulation of the endometrial lining of the uterus, ablation of endometrial implants and/or peritoneal adhesions, soft tissue excisional procedures such as excisional conization of the cervix, intrauterine gynecologic procedures where cutting, ablation, and/or vessel coagulation may be indicated including submucous fibroids, benign endometrial polyps, and uterine septum.

#### Head and Neck/-Otorhinolaryngology (ENT):

For tissue incision, excision, ablation, and vessel hemostasis.

{10}------------------------------------------------

### Hemostasis During Surgery:

For adjunctive coagulation and hemostasis (bleeding control) during surgery in endoscopic (e.g. laparoscopic) and open procedures.

#### Neurosurgery:

For hemostasis for pituitary tumor, meningioma, hemagioblastoma, AVMs. glioblastoma, astrocytoma, oligodendroglioma.

### Oculoplastics:

For incision, excision, vaporization, and/or coagulation of tissues in oculoplastic procedures such as operations on the lacrimal system, operation on the eyelids, removal of biopsy or orbital tumors, enucleation on eyeball, exteneration of orbital contents.

#### Pulmonary Surgery:

For palliative treatment of benign and malignant pulmonary airway obstructions, including squamous cell carcinoma, adenocarcinoma, carcinoid, benign tumors, granulomas, and benign strictures.

#### Thoracic Surgery:

For cutting (incision/excision), coagulating, and vaporization of soft tissue. Thoracic applications, including but not limited to, isolation of vessels for endarterectomy and/or bypass grafts, wedge resections, thoractomy, formation of pacemaker pockets; vaporization, coagulation, incision/excision, debulking, and ablation of lung tissue (thoracoscopy).

#### Urology:

For all applications including superficial urinary bladder tumors, invasive bladder carcinoma, urethral strictures and lesions of the external genitalia (including condyloma acuminata).

#### Orthopedics:

For cutting, ablation, and/or hemostasis of intra-articular tissue in orthopedic surgical and arthroscopic applications.

#### 532 nm wavelength

For the coagulation and hemostasis of vascular lesions.

{11}------------------------------------------------

### Dermatology/Plastic Surgery:

For photocoagulation and hemostasis of vascular and cutaneous lesions in dermatology including, but not limited to, the following general categories: vascular lesions [angiomas, hemangiomas (port wine), telangiectasia (facial or extremities telangiectasias, venous anomalies, leg veins]: benign pigmented lesions (nevi, lentigines, chloasma, café au- lait, tattoos (red and green ink), verrucae, skin tags, keratoses, plaques, cutaneous lesion treatment (hemostasis, color lightening, blanching, flattening, reduction of lesion size.

K032218

4/ 5

#### General Surgery:

Vaporizing, Coagulating, Incising, Excising, Debulking, and Ablating of Soft Tissue as well as in Endoscopic (e.g., laparoscopic) or open surgeries.

#### Gastroenterology:

Tissue ablation and hemostasis in the gastrointestinal tract; Esophageal neoplastic obstructions, including squamous cell carcinoma and adenocarcinoma; Gastrointestinal hemostasis (including Varices, Esophagitis, Esophageal Ulcer, Mallory-Weiss tear, Gastric Ulcer, Angiodysplasia, Stomal Ulcers, Non-bleeding Ulcers, Gastric Erosions); Gastrointestinal Tissue ablation (Benign and Malignant neoplasm, Angiodysplasia, Polyps, Ulcer, Colitis, Hemorrhoids).

#### Head and Neck Otorhinolaryngology (ENT):

Tissue incision, excision, ablation, and vessel hemostasis.

#### Hemostasis during Surgery:

Adiunctive coagulation and hemostasis (bleeding control) during surgery in endoscopic (e.g., laparoscopic) and open surgery.

#### Neurosurgery:

Hemostasis for: Pituitary Tumor, Meningioma; hemagioblastoma; AVMs; Glioma; Glioblastoma: Astrocytoma: Oligodendroglioma.

#### Ophthalmology:

Post-vitrectomy endophotocoagulation of the retina.

### Pulmonary Surgery:

Palliative treatment of benign and malignant pulmonary a airway obstructions, including Squamous Cell Carcinoma, Adenocarcinoma, Carcinoid; Benign Tumors; Granulomas; Benign Strictures.

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#### K032218 2/5

# Thoracic Surgery:

Cutting (incision/excision), coagulating, and vaporizing of soft tissue. Thoracic applications including, but not limited to: Isolation of vessels for endartecetomy and/or by-pass grafts, Wedge Resections, Thoractomy, Formation of Pacemaker pockets. Vaporization, coagulation, incision/excision, debulking, and ablation of lung tissue (Thoracoscopy).

## Urology:

All applications including: Superficial urinary bladder tumors, invasive bladder carcinoma; Urethral Strictures; Lesions of the external genitalia (including condyloma acuminata).