Stryker MultiGen 2 RF Generator and venom needle tips and tricks

[Ligament]

Got one of these now.

For those of you who have experience with this unit:
1. TIps
2. Tricks
3. Pearls with Venom needle. What temp and lesion time do you suggest?
4. Do you find using the venom needle worth the additional cost and do you feel it creates a larger lesion?

Anybody with experience doing pulsed RF treatment on this device?

Thanks in advance.

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[Quito]

Have you heard of the Nimbus needle? Much cheaper than Venom and much bigger lesion.


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[cowboydoc]

Got one of these now.

For those of you who have experience with this unit:
1. TIps
2. Tricks
3. Pearls with Venom needle. What temp and lesion time do you suggest?
4. Do you find using the venom needle worth the additional cost and do you feel it creates a larger lesion?

Anybody with experience doing pulsed RF treatment on this device?

Thanks in advance.

The rep said the company had a 90-something % rate of "deployment" of the venom needle in their studies. I'm going to be generous and call it 80%.

Going through thicker tissue and "fouling" the needle (Sacral ala) drops likelihood of deployment greatly. Sometimes, you can re-introduce the stylet into the cannulae "backwards" then remove to get the probe to deploy properly.

Make sure the venom side-port is not oriented facing os, as this may cause the probe to stay in the cannula and not deploy out the side port.


It's otherwise, I think it's like everything else you've used. It is touchy if the patient moves or the cannula rolls, it will cut out. Nice safety feature, but occasionally shuts you down inadvertently. If it's taking too long to heat or there is a sudden change of impedance, it will cut off the channel. Each runs independently, so you can restart one without affecting the others.

I'm doing 80 deg for 90 seconds in the c-spine and have moved to 90 deg for 90 sec in lumbar and most peripheral applications. While the lesion size is allegedly larger, I'm not sure I'd go so far as to say it's worth the additional cost (if I were paying for it.) I find I will more often do 2 instead of 3 or 1 instead of 2 lesions compared to "non-venom" needles. The time saved doesn't translate to anything of consequence in my situation. If needle cost is coming out of your overhead, not sure it's justifiable.

No pulsed here.

 

[BobBarker]

Venom: 50% of the time, it deploys every time!

 

[Ligament]

The rep said the company had a 90-something % rate of "deployment" of the venom needle in their studies. I'm going to be generous and call it 80%.

Going through thicker tissue and "fouling" the needle (Sacral ala) drops likelihood of deployment greatly. Sometimes, you can re-introduce the stylet into the cannulae "backwards" then remove to get the probe to deploy properly.

Make sure the venom side-port is not oriented facing os, as this may cause the probe to stay in the cannula and not deploy out the side port.


It's otherwise, I think it's like everything else you've used. It is touchy if the patient moves or the cannula rolls, it will cut out. Nice safety feature, but occasionally shuts you down inadvertently. If it's taking too long to heat or there is a sudden change of impedance, it will cut off the channel. Each runs independently, so you can restart one without affecting the others.

I'm doing 80 deg for 90 seconds in the c-spine and have moved to 90 deg for 90 sec in lumbar and most peripheral applications. While the lesion size is allegedly larger, I'm not sure I'd go so far as to say it's worth the additional cost (if I were paying for it.) I find I will more often do 2 instead of 3 or 1 instead of 2 lesions compared to "non-venom" needles. The time saved doesn't translate to anything of consequence in my situation. If needle cost is coming out of your overhead, not sure it's justifiable.

No pulsed here.

Very useful, about to walk into my first venom case as I type. thanks!

 

[unchockey21]

Got one of these now.

For those of you who have experience with this unit:
1. TIps
2. Tricks
3. Pearls with Venom needle. What temp and lesion time do you suggest?
4. Do you find using the venom needle worth the additional cost and do you feel it creates a larger lesion?

Anybody with experience doing pulsed RF treatment on this device?

Thanks in advance.

We use Stryker. 2 of the 4 docs in our group use venom. In my opinion, it’s not worth the extra cost compared to just using a 16G. When I started, I asked the rep why they didn’t make a 16G. “Because we have venom” aka so we can charge triple the price. We got around to doing a cost analysis and it’s just ridiculous the amount of money we were pissing away using Stryker. We were in the middle of trialing competitors when the virus hit.

 

[Ligament]

We use Stryker. 2 of the 4 docs in our group use venom. In my opinion, it’s not worth the extra cost compared to just using a 16G. When I started, I asked the rep why they didn’t make a 16G. “Because we have venom” aka so we can charge triple the price. We got around to doing a cost analysis and it’s just ridiculous the amount of money we were pissing away using Stryker. We were in the middle of trialing competitors when the virus hit.

Yeah that is pretty ridiculous in not making a 16g.

 

[Ferrismonk]

I've only ever used 20G RFA needles. A 16G seems cruel. Are you having a lot of post-procedure pain? Difficulty tolerating despite the local?

 

[lonelobo]

Very useful, about to walk into my first venom case as I type. thanks!

Emergent RF.. please share the indications

 

[Ferrismonk]

Emergent RF.. please share the indications

Severe pain. Limiting opiate consumption.

 

[NJPAIN]

I've only ever used 20G RFA needles. A 16G seems cruel. Are you having a lot of post-procedure pain? Difficulty tolerating despite the local?

Very well tolerated, surprisingly. I don’t think any more difficult than 20 gauge. I also think because they are so stiff they go exactly where you point them.


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[Ligament]

I've used 16ga for years in the thoracic and lumbar spine, love them. Large lesion, no bending, can get them tight against os/mammiloaccesory ligament. I think they mechanically scrape off the medial branches if you place them properly. I routinely get 1-3 years of relief in the lumbar spine. I understand this is outside the literature.

 

[lonelobo]

Severe pain. Limiting opiate consumption.

ummmm....BS

 

[lonelobo]

ummmm....BS No one ever needs an urgent RF

 

[lobelsteve]

Pancreatic CA, celiac
TN. Gasserian.

 

[Ducttape]

someone who pays cash.

 

[lonelobo]

Pancreatic CA, celiac
TN. Gasserian.

Somehow I don't think these are the cases he was doing