ENDOPATH RESPOSABLE TROCAR SYSTEM

K971738 · Ethicon Endo-Surgery, Inc. · GCJ · Aug 7, 1997 · Gastroenterology, Urology

Device Facts

• Record ID: K971738
• Device Name: ENDOPATH RESPOSABLE TROCAR SYSTEM
• Applicant: Ethicon Endo-Surgery, Inc.
• Product Code: GCJ · Gastroenterology, Urology
• Decision Date: Aug 7, 1997
• Decision: SESE
• Submission Type: Traditional
• Regulation: 21 CFR 876.1500
• Device Class: Class 2

Intended Use

The intended use of the New Device is to establish a path of entry for minimally invasive instruments and establishment of pneumoperitoneum.

Device Story

ENDOPATH® Resposable Trocar System consists of single-use obturator (sharp flat blade or pyramidal tip with spring-loaded safety shield) and trocar sleeve housing; reusable trocar sleeve. Used in abdominal, thoracic, and gynecologic minimally invasive surgery to create access for endoscopes and instruments. Obturator shield reduces injury risk during cavity entry. Sleeve housing features inner/outer seals to maintain pneumoperitoneum; optional stopcock for insufflation; integral threads on cannula for tissue stabilization. Operated by surgeons in OR. Device provides physical access path; output is the established port for instrumentation. Benefits include safe cavity entry and maintenance of operative space pressure.

Clinical Evidence

Bench testing only. Evaluations confirmed performance in obturator-sleeve mating, insertion, shield action, removal, tissue security, and pneumoperitoneum maintenance.

Technological Characteristics

System comprises single-use obturator and trocar sleeve housing with reusable trocar sleeve. Sizes: 5mm-12mm diameter, 50mm-150mm length. Features spring-loaded safety shield, inner/outer seals, and optional insufflation stopcock. Cannula includes integral threads for tissue stabilization. Materials allow for cleaning and sterilization of reusable components.

Indications for Use

Indicated for use in abdominal, thoracic, and gynecologic minimally invasive surgical procedures to establish a path of entry for endoscopic instruments and endoscopes.

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.

Submission Summary (Full Text)

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## Aus7,1997

K971738

## 510(k) Summary of Safety and Effectiveness Appendix A

| Statement | Information supporting claims of substantial equivalence, as defined under the Federal Food, Drug and Cosmetic Act, respecting safety and effectiveness is summarized below. For the convenience of the Reviewer, this summary is formatted in accordance with the Agency's final rule "...510(k) Summaries and 510(k) Statements..." (21 CFR §807) and can be used to provide a substantial equivalence summary to anyone requesting it from the Agency. |
|-----------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Device description | The ENDOPATH® Resposable Trocar System consists of three main components: a Single Use obturator, a Single Use trocar sleeve housing and a reusable trocar sleeve. |
| | The obturator consists of a sharp flat blade tip or pyramidal tip and a spring loaded shield. The shield is designed to cover the flat blade or pyramidal tip to reduce the likelihood of injury to internal structures from puncture or laceration once the abdominal or thoracic cavity has been entered. |
| | The trocar sleeve housing has an inner and outer seal to maintain pneumoperitoneum when instrumentation is inserted and withdrawn through the cannula during a surgical procedure. Some trocar sleeve housings are provided with a stopcock for insufflating the operative space. Integral threads along the outside diameter of the cannula portion of the trocar sleeve provide a retention mechanism to stabilize the trocar sleeve in tissue. |
| | The reusable trocar sleeve, supplied smooth or threaded, is manufactured so that it may be cleaned, sterilized, and reused. |
| | The ENDOPATH® Resposable Trocar System shall be provided in a variety of sizes from 5mm to 12mm in diameter and 50mm to 150mm in length. In addition to the size variety they are supplied with or without stopcock for insufflation. |
| Intended use | The intended use of the New Device is to establish a path of entry for minimally invasive instruments and establishment of pneumoperitoneum. |
| Indications statement | The ENDOPATH® Resposable Trocar System has application in abdominal, thoracic, and gynecologic minimally invasive surgical procedures to establish a path of entry for endoscopic instruments and endoscopes. |
| | Continued on next page |

Continued on next page

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## Appendix A 510(k) Summary of Safety and Effectiveness,

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| Technological<br>characteristics | The technological characteristics of the New Device are the same as the Predicate<br>Devices. |
|----------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Performance<br>data | Pre-clinical laboratory evaluations were performed to ensure that the device can be<br>used as designed. The studies demonstrated acceptable performance to the Predicate<br>Devices in mating the obturator with the sleeve, insertion into the operative cavity,<br>shield action to cover blade, removal of the obturator from the sleeve, security of the<br>sleeve in tissue, and maintenance of pneumoperitoneum of the operative space. |
| Conclusion | Based on the 510(k) summaries and 510(k) statements (21 CFR §807) and the<br>information provided herein, we conclude that the New Device is substantially<br>equivalent to the Predicate Devices under the Federal Food, Drug and Cosmetic Act. |
| Contact | Ivan S. Placko<br>Project Manager<br>Regulatory Affairs Department<br>Ethicon Endo-Surgery, Inc.<br>4545 Creek Road<br>Cincinnati, Ohio 45242 |
| Date | May 9, 1997 |

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Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

Mr. Ivan S. Placko Project Manager, Regulatory Affairs Ethicon Endo-Surgery, Inc. 4545 Creek Road Cincinnati, Ohio 45242-2839

AUG ---7 1997_

Re: K971738

Trade Name: ENDOPATH® Resposable Trocar System Regulatory Class: II Product Code: GCJ Dated: May 9, 1997 Received: May 12, 1997

Dear Mr. Placko:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to 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). 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 (Premarket Approval), 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 895. A substantially equivalent determination assumes compliance with the current Good Manufacturing Practice requirements , as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic (QS) inspections, the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory

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Page 2 - Mr. Ivan S. Placko

action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations. ... ......... ... .-

This letter will allow you to begin marketing your device as described in your 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 and additionally 809.10 for in vitro diagnostic devices), please contact the Office of Compliance at [phone]. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at [phone]. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number [phone] or [phone] or at its internet address "http://www.fda.gov/cdrh/dsmamain.html".

Sincerely yours,

icolleto

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

Enclosure

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## Appendix B Indications for Use Statement

Following is the Indications for Use Statement: Statement

> 510(k) Number: K_97173 8 Device Name: ENDOPATH® Trocar

Indications for Use:

The ENDOPATH® Reusable Trocar System has application in abdominal, thoracic, and gynecologic minimally invasive surgical procedures to establish a path of entry for endoscopic instruments and endoscopes.

| Prescription Use | X |
|----------------------|---|
| (Per 21 CFR 801.109) | |

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(Divis

Division of Devices

| 510(k) Number | K971738 |
|---------------|---------|
|---------------|---------|

Ethicon Endo-Surgery, Inc.