Review the Pathway for Approval for New Devices and Procedures prior to completing this application. Click here to submit an application by mail. Name of ASMBS Sponsor* Email of ASMBS Sponsor* Enter Email Confirm Email Name(s) of ASMBS Co-Sponsor(s) New or extinct procedure*There may be procedures there are no longer viable and these may be removed from approval list. New Extinct Device or Surgery* Device Surgery Device: FDA Approval Required* Yes No Surgery: Novel or Similar to Established Procedure* Novel Similar to Established Procedure If similar to established procedure, describe how the new procedure differs from current established procedure.*Do you or your co-sponsors have a financial relationship with the new device or procedure including but not limited to consulting, ownership, proctoring, etc.* Yes No What is the relationship?*Publications with Evidence Grades*Please provide the publications with an evidence grade utilizing established evidence scales such as, Oxford Centre for Evidence-based Medicine – Levels of Evidence (March 2009).Publication ReferenceGrade New Procedure InformationIs this a new procedure or a modification of an existing procedure?* New Modification Based on current knowledge does the new procedure or modification of an existing procedure potentially have a different risk/benefit profile than an existing procedure?*Does it add a new mechanism to an existing procedure?*Does it have a new name or names that should be standardized as part of the approval process?*CAPTCHA