K223039 · Intuitive Surgical · GEI · Nov 28, 2022 · General, Plastic Surgery
Device Facts
Record ID
K223039
Device Name
da Vinci E-200 Electrosurgical Generator
Applicant
Intuitive Surgical
Product Code
GEI · General, Plastic Surgery
Decision Date
Nov 28, 2022
Decision
SESE
Submission Type
Traditional
Regulation
21 CFR 878.4400
Device Class
Class 2
Attributes
Therapeutic
Indications for Use
The da Vinci E-200 Electrosurgical Generator is intended to deliver high-frequency energy for cutting, coagulation and vessel sealing of tissues in da Vinci robotic procedures, and non-robotic open and laparoscopic procedures.
Device Story
Electrosurgical unit (ESU) providing high-frequency (HF) monopolar, bipolar, and advanced bipolar energy; used in da Vinci robotic, open, and laparoscopic surgeries. Operated by surgeons in OR settings. Inputs include user-selected energy modes/power settings via front panel/LCD; outputs include HF electrical energy delivered to compatible instruments. When integrated with da Vinci surgical systems, communicates via Ethernet for control/status; also functions as standalone generator with third-party instruments. Features include audible tones, LED indicators, and LCD status messages. Advanced bipolar modes (Sealing, Sync) automate energy delivery for vessel/tissue bundle sealing and transection. Device assists surgeons in achieving hemostasis and tissue division, potentially reducing operative time and improving surgical precision.
Clinical Evidence
Bench testing only. Included hardware/software verification, EMC/electrical safety, and instrument compatibility. In-vivo porcine model validation confirmed safety/efficacy in simulated robotic/laparoscopic settings. Thermal effects testing demonstrated equivalence to ForceTRIAD. Capacitive coupling evaluation showed no significant increase in unintended energy delivery compared to predicate. Human factors study confirmed usability and safety in integrated and standalone configurations.
Technological Characteristics
Electrosurgical generator providing monopolar (0-120W) and bipolar (0-95W) outputs. Connectivity: Ethernet for da Vinci system integration, auxiliary footswitch ports. User interface: LCD, LED indicators, audible tones. Features Neutral Electrode Contact Quality Monitor (CQM). Advanced bipolar modes use proprietary algorithms to control energy delivery for vessel sealing. Sterilization: Not applicable (generator is capital equipment).
Indications for Use
Indicated for patients undergoing robotic, open, or laparoscopic surgical procedures requiring tissue cutting, coagulation, or vessel sealing. No specific age or gender contraindications stated.
Regulatory Classification
Identification
An electrosurgical cutting and coagulation device and accessories is a device intended to remove tissue and control bleeding by use of high-frequency electrical current.
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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.
November 28, 2022
Intuitive Surgical Shamsa Karimi Senior Regulatory Affairs Specialist 1266 Kifer Road Sunnyvale, California 94086
Re: K223039
Trade/Device Name: da Vinci E-200 Electrosurgical Generator Regulation Number: 21 CFR 878.4400 Regulation Name: Electrosurgical Cutting And Coagulation Device And Accessories Regulatory Class: Class II Product Code: GEI Dated: September 28, 2022 Received: September 29, 2022
Dear Shamsa Karimi:
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,
Zhijie Liao - Digitally signed by Zhijie Liao -S Date: 2022.11.28 14:53:05 -05'00' For Mark Trumbore, PhD Assistant Director DHT4A: Division of General Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Ouality Center for Devices and Radiological Health
Enclosure
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# Indications for Use
510(k) Number (if known) K223039
### Device Name
da Vinci E-200 Electrosurgical Generator
Indications for Use (Describe)
The da Vinci E-200 Electrosurgical Generator is intended to deliver high-frequency energy for cutting, coagulation and vessel sealing of tissues in da Vinci robotic procedures, and non-robotic open and laparoscopic procedures.
| 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 (K223039)
- Submitter: Intuitive Surgical, Inc. 1266 Kifer Road Sunnyvale, CA 94086
Official Contact: Shamsa Karimi Sr. Regulatory Affairs Specialist Phone Number: 408-806-6720-Fax Number: 408-523-8907 Email: shamsa.karimi(@intusurg.com
Date Summary Prepared: November 23, 2022
| Trade Name: | da Vinci E-200 Electrosurgical Generator |
|--------------------|------------------------------------------------------------------------------------------------------------------------------------|
| Common Name: | Electrosurgical Unit (ESU/Generator) |
| Classification: | II<br>21 CFR 878.4400, Electrosurgical cutting and coagulation device and<br>accessories. |
| Product Code: | GEI (Electrosurgical, Cutting & Coagulation & Accessories) |
| Predicate Devices: | Covidien ForceTRIAD Electrosurgical Generator (K110268, primary)<br>Intuitive E-100 Electrosurgical Generator (K191280, secondary) |
### Device Description:
The da Vinci E-200 is an electrosurgical unit (ESU) designed to provide high-frequency (HF) traditional monopolar, bipolar, and advanced bipolar outputs intended for cutting, coagulation and/or vessel sealing of tissues. The da Vinci E-200 is intended to be used with the IS4000/IS4200 da Vinci surgical systems and also operate as a standalone electrosurgical generator. When connected to the da Vinci surgical system, the E-200 provides HF output to da Vinci instruments. Control and status messages are passed between the E-200 and the da Vinci system through an Ethernet communication cable. The E-200 is also compatible with open and laparoscopic third-party handheld monopolar and bipolar instruments, fingerswitch equipped instruments (where applicable) and Intuitive provided auxiliary footswitches. The primary
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function of the E-200 Electrosurgical Generator is to allow a surgeon to deliver HF output to cut, seal, or coagulate human tissue during surgery. The user interface includes audible indicator tones, LED indicators on the front of the generator, and status messages provided on its LCD display.
### Intended Use/Indications for Use:
The da Vinci E-200 Electrosurgical Generator is intended to deliver high-frequency energy for cutting, coagulation and vessel sealing of tissues in da Vinci robotic procedures, and non-robotic open and laparoscopic procedures.
### Technological Characteristics:
The Energy modes supported by E-200 include traditional monopolar and bipolar as well as advanced bipolar energy modes as described below.
### Monopolar Energy Modes
The generator provides five monopolar modes to support a range of tissue effects, which can be used with compatible monopolar da Vinci instruments or compatible third-party instruments. Descriptions of the generator monopolar energy modes are listed below. The power settings for all monopolar modes can be adjusted from 0-120 watts.
#### Monopolar Cut Modes ●
Pure: provides clean, precise tissue division with little or no hemostasis. Blend: is a blended waveform that provides tissue division properties with some hemostasis.
#### Monopolar Coagulation Modes ●
Precise: provides a balance of hemostasis and division capability for precise coagulation energy applications. The width of the tissue effect can be narrower than Fulgurate mode.
Fulgurate: provides coagulation with some tissue division.
Spray: provides coagulation with limited tissue division properties. The width of the tissue effect can be wider compared to Fulgurate mode.
### Bipolar Energy Modes
The generator produces four traditional bipolar modes to support a range of tissue effects, which can be used with compatible bipolar da Vinci instruments or compatible third-party instruments. Descriptions of the bipolar energy modes are listed below. The power settings for bipolar energy can be adjusted from 0-95 watts.
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#### ● Bipolar modes
Macro: provides high intensity output for tissue division or rapid hemostasis. Standard: provides moderate intensity output for traditional bipolar application. Low: provides low intensity output for precise control over tissue desiccation.
- Low with Auto Stop: provides the same bipolar output as Low and automatically stops delivering bipolar radio frequency (RF) energy based on a pre-determined threshold. Low with Auto Stop is designed to reduce the potential for excessive thermal effect.
## Advanced Bipolar Energy Modes
Advanced bipolar energy modes are designed for specific advanced energy instruments, and the algorithms used on the E-200 were developed to functionally replicate those used on the predicate device, the E-100 generator. Like the predicate device, the E-200 generator delivers two bipolar advanced energy modes for sealing and transection of vessels and tissue bundles, and also provides a traditional bipolar coagulation mode that can be used for general hemostasis without vessel sealing. Advanced energy modes are compatible only with da Vinci advanced energy instruments; SynchroSeal (K191280) and Vessel Sealer Extend (K183107).
#### Advanced Bipolar Modes ●
Coagulation Mode: It is a traditional bipolar mode used for general tissue coagulation and has a fixed target output power of 50 W.
- Sealing Mode: It is designed to seal vessels and tissue bundles when used with the da Vinci Vessel Sealer Extend and SynchroSeal. The generator determines when the seal cvcle is complete thereby delivering the required amount of energy necessary to successfully seal vessels.
- Sync Mode: It is specifically designed for use with SynchroSeal for single-step sealing and transection of vessels and tissue bundles. The Sync mode uses a unique algorithm to control the energy output delivery to the seal and cut electrodes on the instrument. The generator automatically determines when the Sync mode cycle is complete, resulting in a single-step hemostatic transection of vessels and soft tissue.
## Performance Data:
The E-200 Electrosurgical Generator was evaluated using design verification (bench testing), human factors testing, packaging(includes transit testing), and validated using in-vivo and exvivo models to demonstrate that the design output meets both the design input requirements and the user needs, and the generator performs as intended.
## Design Verification (bench testing):
The subject device, E-200 Electrosurgical Generator, was subjected to series of tests to evaluate performance and to demonstrate that the design outputs meet the design input requirements. The
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design verification testing provided confirmation that the device meets the requirements for the following:
- Hardware requirements o
- EMC and Electrical Safety requirements ●
- Software requirements including Cybersecurity ●
- System interface requirements .
- Instrument compatibility requirements ●
- Packaging and Labeling 0
Design Validation; in-vivo testing with a porcine model was used to evaluate the safety and efficacy of the E-200 generator, its accessories and its interaction with intended robotic systems, da Vinci and third-party instruments and accessories in a representative simulated surgical setting. Design validation demonstrated that the design outputs fulfill the user needs and that the intended use have been met.
Thermal effects testing was conducted to demonstrate the ability of the subject E-200 generator to create comparable thermal effects on tissue to the predicate ForceTRIAD generator (K110268), the primary predicate. The E-200 generator was found to have acceptable thermal effects when compared to the ForceTRIAD generator.
Neutral electrode contact quality monitor (CQM) study was conducted to evaluate the performance of the CQM system on the subject E-200 generator for conformance to the IEC standards. The study validated the use of the Covidien E7507 neutral electrode (commercially available product) with the E-200 generator for CQM functionality.
The E-200/E-100 vessel sealing bench testing compared the HF output characteristics of the E-200 to the predicate E-100 device (K191280). The test demonstrated that the HF output characteristics of the two generators are substantially equivalent and that there are no differences which would be expected to result in a change in the vessel sealing performance.
An evaluation of the capacitive coupling behavior of the E-200 generator was performed using third party laparoscopic monopolar accessories which included instruments and cannulas. This validation demonstrated that the E-200 generator had no significant increase in unintended capacitively coupled energy delivery when compared to the predicate Covidien ForceTriad generator.
### Human Factors Evaluation:
The Usability Validation Study evaluated the use safety and usability of the E-200 generator along with its associated accessories with intended robotic systems in integrated and standalone
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configurations. The usability validation study demonstrated that the E-200 electrosurgical generator could be used safely and effectively by the intended users in the intended use environment.
## Summary:
The evaluation of the E-200 Electrosurgical Generator raises no new questions of safety or effectiveness and demonstrates that the E-200 design outputs meet the design input requirements and user needs and is substantially equivalent to the predicate devices, Covidien ForceTRIAD Electrosurgical Generator (K110268) and Intuitive E-100 Electrosurgical Generator (K191280).
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.