Ablation apparatus and system to limit nerve conduction
An electrosurgical probe including a probe body which defines a longitudinal probe axis. The electrosurgical probe also includes a first and second conductive electrode, each disposed along the probe axis. The surface area of the first conductive electrode is greater of the surface area of the second conductive electrode. The ratio of the surface area of the first conductive electrode to the surface area of the second conductive electrode may be adjustable. Another aspect of the present invention is an electrosurgical probe having a probe body which defines a single longitudinal probe axis. The electrosurgical probe of this aspect of the invention further includes more than two electrodes operatively disposed at separate and distinct positions along the axis of the probe body. The electrodes may be selectively connected to one of or a combination of a stimulation energy source, an ablation energy source or a ground for either energy source. Another aspect of the present invention is a method of placing an electrosurgical probe such as described above for specific ablation procedures.
1. A method of treating a nerve comprising:
inserting a single longitudinal probe through a single puncture site in a layer of skin;
directing the probe tip towards the nerve;
delivering a stimulating current through an electrode on the probe, observing a response of a muscle associated with the nerve; and
applying an ablation current to ablate the nerve at a first location upon observing the response;
moving the probe in a direction axially along the nerve without removing the probe from the puncture site;
applying additional ablation current to further ablate the nerve at a subsequent location to more effectively terminate a signal conduction through the nerve.
2. The method of claim 1 , where moving the probe in the direction relative to the nerve comprises moving the probe and repeating delivering of the stimulating current through the electrode on the probe and Observing a response of the muscle associated with the nerve to determine if a desired level of conduction is achieved for completion of the treatment.
3. The method of claim 1 , where moving the probe in the direction relative to the nerve comprises moving the probe in a forward direction distally to a first ablation area along the nerve.
4. The method of claim 1 , further comprising performing rotating motions with the probe to increase an area of ablation and permanence of the procedure.
5. The method of claim 1 , moving the probe in a direction relative to the nerve without removing the probe from the puncture site.
6. The method of claim 1 , where delivering the stimulating current and observing, the response of the muscle associated with the nerve comprises relocating the probe closer to the nerve if the response is not observed and repeating delivering of the stimulating current.
7. The method of claim 1 , where moving the probe in the direction comprises moving the probe up, down, near, far, circular, or in a pattern.
8. A method of locating and treating a nerve comprising:
inserting a single longitudinal probe through a single puncture site in a layer of skin;
positioning the probe tip in close proximity to said nerve;
delivering a stimulating current through an electrode on the probe;
not detecting a response of a muscle associated with said nerve;
readjusting the position of the probe tip;
delivering a stimulating current through an electrode on the probe;
observing a response of a muscle associated with said nerve and observing a degree of the response;
ablating the nerve at a first location with the probe tip; and
moving the probe in a direction axially along the nerve without removing the probe tip from the puncture site and ablating the nerve at a second location to more effectively terminate a signal conduction through the nerve.
9. The method in claim 8 wherein, said readjusting the probe tip position is performed through a single puncture site without withdrawing the probe out of the puncture site.
10. The method of claim 9 , further comprising delivering ablation energy to the nerve to terminate a signal conduction through the nerve; and advancing the probe in a distal direction along the nerve to stimulate and ablate a second area along the nerve.
11. A method of ablating a nerve comprising:
locating the nerve by inserting a single longitudinal probe through a single puncture site in a layer of skin;
positioning the probe tip in close proximity to said nerve;
delivering a stimulating current through an electrode on the probe;
observing a response of a muscle associated with said nerve and observing a degree of the muscle response to determine a proximity of the electrode to the nerve;
ablating the nerve by delivering energy through electrodes on said probe sufficient to ablate the nerve at a first location;
confirming the ablation of the nerve by delivering a stimulating current through an electrode on the probe to determine feedback as to a quality of the ablation; and
moving the probe tip axially along said nerve to ablate to the nerve at a second location axially spaced from the first location without removing the probe tip from the nerve.
12. The method in claim 11 , wherein, said locating, ablating and confirming is performed through a single puncture site without withdrawing the probe out of the tissue.
13. The method of claim 11 , wherein, the nerve is ablated in multiple sites.
14. The method of claim 13 , wherein, the nerve ablation sites are sequential in the direction of insertion of the probe.
15. The method of claim 13 , wherein, the nerve ablation sites are sequential in the direction of withdrawal of the probe.