Electrocautery rhizotomy using wanding of energized electrocautery probe
A cautery probe is provided for performing a rhizotomy through an incision in the body of a patient. The probe includes a rigid shaft that can be inserted through an incision, and a distal cutting tip that can be energized and wanded across a target nerve. In embodiments, the probe also includes connectors for attaching a syringe, drawing medication into the syringe, and dispensing medication from the syringe through the probe and adjacent the cutting tip.
1 . A cautery probe for coupling to a radiofrequency (RF) generator comprising:
a rigid shaft having a proximal end, a tapered distal end, a central longitudinal axis extending between the proximal and distal ends, an electrode extending through the shaft parallel to the longitudinal axis, and a fluid lumen extending through a portion of the shaft axially offset from the electrode, the fluid lumen having a proximal opening and a distal exit in the tapered distal end of the rigid shaft, the distal end of the shaft adapted to form a fluid tight seal within a Luer connector,
a first fluid connector coupled to the shaft and in fluid communication with the proximal opening, the first fluid connector having a central axis axially offset from the longitudinal axis;
a solid metal tip longitudinally fixed at the distal end of the shaft and coupled to the electrode, the distal exit of the fluid lumen opening adjacent the metal tip,
the proximal end of the shaft adapted to be coupled to the RF generator to deliver RF energy from the RF generator to the metal tip,
the tapered distal end of the shaft facilitating percutaneous insertion through an incision and into a patient.
2 . The cautery probe of claim 1 , wherein the distal end of the shaft is tapered and adapted to form a friction fit within a Luer connector.
3 . A cautery probe system for use with a radiofrequency (RF) generator for treatment of a patient, comprising:
a) a cautery probe including,
a rigid shaft having a proximal end, a distal end, a longitudinal axis extending from the proximal end to the distal end, an electrode extending through the shaft parallel to the longitudinal axis, and a fluid lumen extending through at least a portion of the shaft, the fluid lumen having a proximal opening and a distal exit, the proximal end of the shaft adapted to be coupled to the RF generator to deliver RF energy from the RF generator to the metal tip;
a first fluid connector coupled to the shaft and in fluid communication with the proximal opening, the first fluid connector having a central axis axially offset from the longitudinal axis,
a metal tip at the distal end of the shaft and coupled to the electrode, the distal exit of the fluid lumen opening at or adjacent the cutting tip;
b) a vial adapter, including,
a receiver adapted to be removably engaged to the distal end of the shaft, and
a needle extending from in and fluid communication with the receiver; and
c) a syringe having a second fluid connector that is adapted to mate with the first fluid connector.
4 . The system of claim 3 , wherein the receiver is adapted to engage the distal end of the shaft in an interference fit without the metal tip bottoming out within the receiver.
5 . The system of claim 3 , wherein the distal end of the shaft has a Luer taper, and the receiver has a female Luer fitting.
6 . The system of claim 3 , wherein the needle has a piercing tip.
7 . The system of claim 3 , wherein the needle is adapted to pass through a septum or other closure of a medication vial.
8 . The system of claim 3 , wherein the cautery probe includes a handle separable from the shaft, the handle including controls to actuate the delivery of RF energy from the RF generator to the metal tip.