Reach and CQ'ENCE Circular Staplers
K192566 · Reach Surgical, Inc. · GDW · Oct 17, 2019 · General, Plastic Surgery
Device Facts
| Record ID | K192566 |
| Device Name | Reach and CQ'ENCE Circular Staplers |
| Applicant | Reach Surgical, Inc. |
| Product Code | GDW · General, Plastic Surgery |
| Decision Date | Oct 17, 2019 |
| Decision | SESE |
| Submission Type | Special |
| Regulation | 21 CFR 878.4750 |
| Device Class | Class 2 |
| Attributes | Therapeutic |
Intended Use
The CQ ENCE Circular Staplers have application throughout the alimentary tract for the creation of end-to-end, side-to-side and end-to-side anastomoses in both open and laparoscopic surgeries.
Device Story
Sterile, single-use, hand-held, non-powered circular stapler; used in general surgery for alimentary tract anastomoses. Device places double-staggered circular row of titanium staples while simultaneously resecting tissue. Surgeon manually activates device via trigger; controls tissue compression by varying closed staple height. Features include anvil, cartridge, instrument shaft, trigger, safety release, wing nut, staple height indicator, and ancillary trocar. Audible indicator clicks when device is fully open for safe removal. Used in OR by surgeons; provides mechanical tissue joining and resection. Benefits include standardized anastomosis creation and adjustable compression for varying tissue requirements.
Clinical Evidence
Bench testing only. Performance data demonstrated compliance with specifications for visual inspection, dimensional analysis, staple form, and safety mechanism performance, consistent with predicate K120179.
Technological Characteristics
Materials: ASTM F 67 unalloyed titanium staples; polycarbonate and stainless steel end effector; stainless steel shaft; polycarbonate handle. Lubricant: PTFE and silicone grease. Energy: Manual. Dimensions: 21mm, 25mm, 28mm, 31mm, 34mm head diameters; 27cm or 35cm shaft lengths. Sterilization: EtO (SAL 10^-6). Connectivity: None (mechanical).
Indications for Use
Indicated for patients requiring alimentary tract anastomoses (end-to-end, side-to-side, end-to-side) in open or laparoscopic surgeries.
Regulatory Classification
Identification
An implantable staple is a staple-like device intended to connect internal tissues to aid healing. It is not absorbable.
Predicate Devices
- REACH Circular Staplers (K120179)
Related Devices
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- K172361 — EEA Circular Stapler with Tri-Staple Technology · Covidien · Feb 16, 2018
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- K100723 — DISPOSABLE CIRCULAR STAPLER, DISPOSABLE CIRCULAR STAPLER MODEL KYGW-25.5, KYGW-28.5 · Changzhou Kangdi Medical Stapler Co., Ltd. · Apr 30, 2010
Submission Summary (Full Text)
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October 17, 2019
Reach Surgical, Inc. % Rich Grant Official Correspondent SeCQure Surgical 4480 Lake Forest Dr. Cincinnati. Ohio 45242
Re: K192566
Trade/Device Name: Reach and CQ'ENCE Circular Staplers Regulation Number: 21 CFR 878.4750 Regulation Name: Implantable Staple Regulatory Class: Class II Product Code: GDW Dated: September 6, 2019 Received: September 18, 2019
Dear Rich Grant:
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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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
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requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.
For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).
Sincerely,
Cindy Chowdhury, Ph.D., M.B.A. Acting Assistant Director DHT4B: Division of Infection Control and Plastic Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health
Enclosure
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# Indications for Use
510(k) Number (if known) K192566
Device Name CQ'ENCE TM Circular Staplers
Indications for Use (Describe)
The CQ ENCE Circular Staplers have application throughout the alimentary tract for the creation of end-to-end, side-toside and end-to-side anastomoses in both open and laparoscopic surgeries.
| Type of Use (Select one or both, as applicable) |
|-------------------------------------------------|
|-------------------------------------------------|
X Prescription Use (Part 21 CFR 801 Subpart D)
| Over-The-Counter Use (21 CFR 801 Subpart C)
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# 510(K) Summary
#### I. SUBMITTER
Rach Surgical Inc. 120 Xinxing Road West Zone, TEDA Tianjin, Tianjin CHINA 300462
Contact Person: Richard Grant Phone: 513-608-4017 Email: rgrant@secquresurgical.com
Date Prepared: September 6, 2019
#### II. DEVICE
Name of Device: Reach™ and CQ ENCE™ Circular Stapler Common or Usual Name: Circular Stapler Classification Name: Staple, implantable (21 CFR 878.4750) Regulatory Class: II Product Code: GDW
III. PREDICATE DEVICE
REACHTM Circular Staplers, (K120179)
#### IV. DEVICE DESCRIPTION
The REACH™ and SeCQure CO'ENCE™ Circular Staplers (CO'ENCE™ Circular Staplers) are sterile, single-use, hand-held, non-powered stapling devices used during general surgical procedures for the creation of end-to-end, side-to-side and end-to-side anastomoses in both open and laparoscopic surgeries.
The Circular Staplers place a double-staggered, circular row of titanium staples while simultaneously resecting tissue when the device is manually activated. The device is provided in five head diameter sizes: 34mm, 31mm, 28mm, 25mm, and 21mm (product codes CS34, CS31, CS28, CS25, and CS21 respectively). Each size device can be purchased with a standard 27cm length shaft. The CS21 and SC25 can also be purchased with a longer, 35cm shaft (product codes CS21L, CS25L) to facilitate surgeon access to desired tissues.
The CQ 'ENCE™ Circular Stapler allows the surgeon to control tissue compression by varying the closed staple height. The CQ ENCE Circular Stapler forms traditional B-shaped staples that are comprised of titanium. Safe removal of the device is facilitated by opening the instrument one full the Audible Indicator makes a clicking sound.
#### V. INDICATIONS FOR USE
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The CQ ENCE Circular Staplers have application throughout the alimentary tract for the creation of endto-end, side-to-side and end-to-side anastomoses in both open and laparoscopic surgeries.
### VI. COMPARISON OF TECHNOLOGICAL CHARACTERISTICS WITH THE PREDICATE DEVICE
The Reach™ and CQ 'ENCE™ Circular Stapler has the same technological characteristics as the predicate device with the exception of an additional device size and minor technological characteristics as described below
| Product | Reach TM and SeCQure CQ'ENCETM<br>Circular Stapler (Subject) | Predicate ReachTM Circular<br>Stapler<br>(K120179) | Comparison |
|------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Anatomical Site Used | Various soft tissues accessible during<br>laparoscopic procedures | Various soft tissues accessible<br>during laparoscopic procedures | Same |
| Product Models Provided | SeCQure CQ'ENCETM 1<br>CS34, CS31, CS28, CS25, CS25L,<br>CS21, CS21L<br>ReachTM 1<br>ACS34D, ACS31D, ACS28D,<br>ACS25D, ACS25DL, ACS21D<br>ACS21DL | RCS34D, RCS31G, RCS28G,<br>RCS25G, RCS23G,<br>RCS17G | Equivalent. The subject<br>device is provided in a<br>21mm size which is<br>within the previously<br>cleared range and was<br>cleared in K071023. The<br>17 mm size is<br>discontinued. The models<br>are available in two brand<br>types, ReachTM or<br>SeCQure CQ'ENCETM,<br>which are the same with<br>the exception of branding. |
| Cutting Mechanism | Circular Knife | Circular Knife | Same |
| Method of Activation | Single Trigger manually activated | Single Trigger manually activated | Same |
| Disposable/Reusable | Disposable | Disposable | Same |
| Safety Mechanism | Firing Safety with Out-of-Range<br>Lockout | Firing Safety with Out-of-Range<br>Lockout | Same |
| Main Device<br>Features/Components | Anvil<br>Cartridge | Anvil<br>Cartridge | Same |
| | Instrument Shaft | Instrument Shaft | |
| | Trigger | Trigger | |
| | Safety Release | Safety Release | |
| | Wing Nut | Wing Nut | |
| | Staple Height Indicator | Staple Height Indicator | |
| | Ancillary Trocar | Ancillary Trocar | |
| | Shaft | Shaft | |
| | Staple | Staple | |
| Materials | Staples: ASTM F 67 Unalloyed<br>Titanium | Staples: ASTM F 67 Unalloyed<br>Titanium | Equivalent. A<br>biocompatible lubricant<br>was added to the<br>manufacturing process in<br>the current configuration. |
| | End Effector: polycarbonate and<br>stainless steel | End Effector: polycarbonate and<br>stainless steel | |
| | Shaft: stainless steel | Shaft: stainless steel | |
| | Handle: polycarbonate | Handle: polycarbonate | |
| | Lubricant: PTFE & Silicone Grease | Lubricant: Silicone Grease | |
| Staple Shape | Standard "B" shaped staple | Standard "B" shaped staple | Same |
| Staple Height (open) | 3.5 and 4.8 mm | 3.5 and 4.8 mm | Same |
| Staple Height (closed) | 1.0 to 1.8 for 3.5 mm Staples<br>1.2 to 2.2 mm for 4.8 mm staples | 1.5 and 2.2 mm | Same staple height. The<br>Staple Height labeling has<br>been amended to align<br>with industry standard to<br>describe the range of<br>staple heights to be<br>selected by the user. The<br>staple height remains<br>adjustable in the control<br>of the user. |
| End Effector Diameters | 34mm, 31mm, 28mm, 25mm, and<br>21mm | 34mm, 31mm, 28mm, 25mm,<br>23mm and 17 mm | Equivalent. The subject<br>device is provided in a<br>21mm size which is<br>within the previously<br>cleared range. The 17 mm<br>size is being discontinued. |
| Shaft Length | Standard (27cm), Long (35 cm) | Standard (27cm), Long (35 cm) | Same |
| Markings on Handle | Printed instructions for opening | None | Equivalent. Printed instructions were added for ease of use. |
| Anvil Tilt | Anvil Tilt Feature not offered | Anvil Tilt Feature offered | Equivalent. The Anvil Tilt feature is no longer offered as non-tilting is a standard for circular staplers. |
| Opening Method | Turn the Wing Nut counterclockwise one half to a full turn until the Audible Indicator clicks | Turn the Wing Nut counterclockwise one half to a full turn | Equivalent. Opening is the same. An audible click has been added to indicate to the user when the device is fully open. |
| Biocompatibility | Stapler is biocompatible for blood/bone/tissue contact for limited duration<br>Staples are biocompatible for permanent implantation | Stapler is biocompatible for blood/bone/tissue contact for limited duration<br>Staples are biocompatible for permanent implantation | Same |
| Endotoxin Limit | 0.5 EU/mL (20 EU/Device) | 0.5 EU/mL (20 EU/Device) | Same |
| Sterilization Method | EtO, SAL 10-6 | EtO. SAL 10-6 | Same |
| Packaging | Tyvek covered tray in cardboard box | Tyvek covered tray in cardboard box | Same |
| Shelf Life | 5 years | 5 years | Same |
Table 1: Technological Characteristics
<sup>4</sup> Note: The Reach and SeCQure CQ ENCE™ products are the same products with different branding i.e. the CS34 is the 34mm size SeCQure branded CQ ENCE™ Stapler and the ACS34D is the 34mm size Reach™ branded CQ ENCE™ Stapler. The devices are the same other than the branding on the labels and pad printed branding on the handles.
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### PERFORMANCE DATA VII.
Reach™ Circular Stapler performance bench testing was provided in K120179. Testing for the Reach™ and CQ 'ENCE™ Circular Stapler is provided in Section 018 - Performance Testing - Bench of this submission to the same specifications as the Reach™ Circular Stapler previously provided in K120179. The data demonstrates that the Reach™ and CQ ENCE™ Circular Stapler meets the same specifications for visual inspection, dimensional analysis, staple form and safety mechanism performance. The materials used in the device, packaging, and sterilization method remain unchanged.
### VIII. CONCLUSIONS
The CQ 'ENCE™ Circular Stapler has the same intended use and principles of operation as its predicate device. The minor differences in technological characteristics do not change the device use or application and have been tested to the same standards as the currently marketed devices. There are no new issues of safety or effectiveness. The CQ ENCE™ Circular Stapler is substantially equivalent to the predicate device.