Ablation Probe Handle

Abstract

An ablation probe handle (114; 214) for use with an ablation probe (112; 212), the ablation probe being suitable for use with the internal anatomical structure access system (102), the ablation probe handle (114; 214) comprising: a housing (126; 216) adapted for grasping by a user; a lead cable connection interface (128; 228) adapted for connection to a lead cable (116; 216) supplying a microwave source and defining a lead cable connection axis (X); an ablation probe mount (134) adapted for mounting an ablation probe catheter (122; 222) within the housing (126; 226); and a working channel connection interface (130; 230) adapted for connection to a working channel (110; 210) of the internal anatomical structure access system (102), wherein the ablation probe catheter (122; 222) is connected to the handle (114; 214) via the working channel. The working channel connection interface (130; 230) is positioned to extend from the housing (126; 226) along the working channel (110; 210), and the working channel connection interface (130; 230) defines a working channel connection axis (Y), and wherein the lead cable and the working channel connection axis are parallel and offset from each other, and the connection interfaces (128; 228; 130, 230) are positioned such that when the working channel (110; 210) and lead cable (116; 216) are connected to the handle (114; 214), the working channel (110; 210) extends from the housing (126; 226) relative to the housing in the same direction as the lead cable (116; 216). Also disclosed are a handle system and an ablation system.

Description

[Technical Field]

[0001] This application relates to an ablation probe handle, particularly an ablation probe handle suitable for use with an internal anatomical structure access device such as an endoscope. The ablation probe may be a microwave ablation probe. [Background technology]

[0002] Thermal ablation can be used to destroy tissue growths in the body that may be malignant. Current ablation systems use applicators that deliver radio frequency (RF) energy, or more specifically, microwave energy, to the tissue surrounding the applicator tip. This results in localized heating and destruction of malignant cells.

[0003] Microwave ablation systems generally include a microwave ablation probe used to administer microwave ablation treatment to tissue. Microwave ablation probes can be used endoscopically so that they can be used to reach difficult-to-access ablation sites within the body, such as within the lungs. Ablation probes may therefore have a long catheter that includes a feed cable that provides microwave signals to an applicator or antenna at the distal end of the ablation probe. The catheter is inserted into the working channel of an endoscope or similar internal anatomical access device and then carefully positioned at the ablation site before ablation treatment begins.

[0004] The proximal end of the catheter is provided with a handle that allows the user to manipulate the ablation probe. The handle provides an interface that allows connection to the working channel of an endoscope through which the ablation probe is inserted. The handle should allow the user to precisely control the position of the distal tip of the working channel and the position of the ablation probe inserted into the working channel so that it can be positioned to perform ablation at the desired location. The handle also serves as an interface point through which the catheter is connected to a microwave signal generator and / or a coolant supply source. For example, the handle may be connected using lead cables to an ablation console that houses a microwave generator and a coolant pump that pumps coolant between the microwave generator and the distal tip of the probe.

[0005] Known handles for ablation probes have a number of drawbacks. The lead cables used to connect the handle to the ablation console are often thick and heavy. Connecting these lead cables to the handle often makes the handle unwieldy and difficult to precisely control. The lead cables can provide leverage against their connection to the handle and working channel. This can make it difficult to maintain the ablation probe's position while positioning it at the desired ablation site, and also difficult to keep it stationary during ablation. These difficulties can result in the need for splints to support the handle and lead cables during use, which can be time-consuming and still unstable.

[0006] It is also important for a handle to have a natural and comfortable grip while allowing easy access to its controls during use. It should be easy to use by pulmonologists or thoracic surgeons, who are often trained to operate the scope with their non-dominant hand and the primary tool (e.g., the ablation probe) with their dominant hand. Without a handle that is comfortable and natural to grip, it can be difficult to accurately position the working channel and ablation probe at the desired ablation site and maintain their position during the ablation treatment.

[0007] It is desirable for the ablation probe handle to be usable with many different types of intra-anatomical delivery systems and to safely integrate electrical and cooling connections without adversely affecting the ablation procedure. Summary of the Invention [Problem to be solved by the invention]

[0008] The present application aims to provide an ablation probe handle that overcomes one or more of the above-mentioned design challenges. [Means for solving the problem]

[0009] In a first aspect, the present application provides an ablation probe handle for use with an ablation probe, the ablation probe being suitable for use with an internal anatomical structure access system, the ablation probe handle comprising: a housing adapted for gripping by a user; a lead cable connection interface defining a lead cable connection axis adapted for connection to a lead cable supplying a microwave source; an ablation probe mount adapted to mount the catheter of the ablation probe within the housing; and A working channel connection interface adapted for connection to a working channel of an internal anatomical structure access system - Patent Application 20070122997 wherein the catheter of the ablation probe is positioned to extend from the housing along the working channel when the working channel is connected to the handle, and the working channel connection interface defines a working channel connection axis; wherein the lead cable and working channel connection axes are parallel and offset from one another; and Here, the connection interface is positioned so that when the working channel and lead cable are connected to the handle, the working channel extends from the housing to the housing in the same direction as the lead cable.

[0010] This location of the connection interfaces and their respective connection shafts can improve weight distribution of the lead cables and handles and can be configured to reduce strain on the working channel connections. Separation between the connection shafts can create a fulcrum about which the handle can be more easily manipulated, allowing the ablation probe to be more easily and accurately positioned at the ablation site.

[0011] The ablation probe mount may be adapted to secure the catheter of the ablation probe within the housing such that an exposed portion of the length of the catheter is formed outside the housing. The exposed portion may be proximal along the length of the catheter to a point where the catheter extends from the working channel connection interface. The catheter may be movable along the working channel by adjusting the length of the exposed portion outside the housing.

[0012] Ablation probe mounts include: for connection to the proximal end of the catheter of the ablation probe such that the proximal end is fixed relative to the housing; and an exposed portion of the length of the catheter formed outside the housing and a sliding portion of the catheter relatively sliding through the housing and then positioned to pass through the working channel to guide the path of the catheter; It may be compatible.

[0013] The exposed portion may be a loop of catheter outside of the housing that can be extended or retracted from the housing to adjust the position of the ablation probe along the working channel. The exposed portion of the catheter may provide tactile feedback to the user to control the position of the ablation probe along the working channel.

[0014] The housing may have a first portion and a second portion. The lead cable connection interface may be provided in the first portion of the housing. The ablation probe mount may be adapted to secure a catheter of the ablation probe to the first portion of the housing (e.g., connected to a lead cable within the first portion of the housing) and to slidably secure the catheter to the second portion of the housing. The working channel connection interface may be provided in the second portion of the housing. The first portion of the housing may be slidable relative to the second portion of the housing, allowing the catheter to slide along the length of the working channel. This may allow a user to move the ablation probe along the length of the working channel by moving the first and second portions of the housing relative to one another.

[0015] The handle may include a catheter locking mechanism that may be movable between an unlocked state in which the catheter is slidable relative to the housing and an unlocked state in which the catheter is not slidable relative to the housing, which may allow a user to fix the position of the ablation probe relative to the handle when it is in the desired position for ablation.

[0016] The handle may include a sliding mechanism. The sliding mechanism may include a sliding component in which the working channel connection interface is located. The sliding component may be slidable relative to the housing to allow independent movement of the working channel relative to the catheter.

[0017] The sliding mechanism can be used in combination with the catheter locking mechanism by using the sliding mechanism to lock the ablation probe in position relative to the handle and then move the working channel relative to the ablation probe while maintaining the ablation probe in a fixed position to expose the distal end of the ablation probe from within the working channel before activating ablation.

[0018] The housing may include an elongated grip portion adapted to be grasped by a user in one hand, and may be shaped and configured to be grasped using a left-handed grip or a right-handed grip.

[0019] The grip portion may have a non-circular cross-sectional shape. The non-circular profile may be elongated with a major axis longer than the orthogonal minor axis. The cross-sectional shape may include two flat portions connected by two curved portions. The handle may include one or more controls (e.g., an actuator or other user-activated button or input interface). The one or more controls may be spaced apart along the length of the housing from the grip portion. The one or more controls may be spaced apart proximally along the length of the housing. The controls may be spaced apart from the grip portion to allow the user's thumb to reach them while their fingers are wrapped around the grip portion. This may allow the user to operate the controls without having to reposition their grip. The controls may include a control for a catheter locking mechanism used to secure the catheter in place.

[0020] The handle may include one or more visual indicators that indicate the status of the ablation procedure, such as one or more colored lights (e.g., LEDs) with different colors corresponding to different statuses involving the ablation procedure.

[0021] The grip portion may define a grip axis around which the housing is grasped by a user. The grip axis may be offset relative to the working channel connection axis. The grip axis may be the central longitudinal axis of the portion of the housing that is grasped by a user. By offsetting the grip axis, a fulcrum may be formed between the handle and the working channel. This allows for easier manipulation of the handle when connected to the working channel compared to when the grip axis is aligned with the working channel.

[0022] The working channel connection interface may be adapted to form a rotatable coupling with the working channel (e.g., between the working channel and the handle), allowing the handle to rotate about the working channel connection axis during use. This may allow the user to rotate the handle about the axis of the working channel, thus providing a comfortable position during use. This may also allow the user to select a left-handed or right-handed grip as desired.

[0023] A portion of the length of the lead cables may extend along a portion of the length of the handle. The lead cables may extend within or alongside a portion of the housing, which may allow the lead cables to form a rigid "core" of the handle.

[0024] The housing may include a recess in which the working channel or lead cable connection interface is located, which may provide space for the working channel to connect (e.g., including any adapters or other components at the proximal end of the working channel) and may allow for use with a variety of different internal anatomical access systems.

[0025] The microwave ablation probe handle may further include a manifold adapted to connect the lead cables and catheters of the ablation probe, the manifold being configured to form an electrical connection between the lead cables and the ablation probe when connected.

[0026] The lead cables may be configured to carry a flow of coolant, and the manifold may be configured to form a fluid connection between the catheter and the lead cables when connected.

[0027] The manifold may provide a secure electrical and / or fluid connection between the lead cables and the ablation probe within the handle without adversely affecting the ablation procedure.

[0028] The manifold may have minimal fluid and / or electrical connection distances within the handle.

[0029] The manifold may include an RF connector (such as a coaxial connector (e.g., an MCX connector)) configured to form an electrical connection between a feed cable and a lead cable included in the catheter of the ablation probe.

[0030] The manifold may include a coolant inlet channel positioned to provide a supply of coolant from the lead cable to the catheter of the ablation probe.

[0031] The manifold may include coolant outlet channels positioned to carry a return flow of coolant from the catheter to the lead cables of the ablation probe. The manifold may be configured to minimize its length, and therefore the length of the power supply cables contained within the catheter.

[0032] According to a second aspect, there is provided a handle system comprising the ablation probe handle of the first aspect. The handle system may further comprise a connector capable of connecting the lead cable to the working channel (when they are connected to the handle) at a point along the lead cable spaced from the housing. This may provide additional structural strength by utilizing the strength of the lead cable.

[0033] According to a third aspect, there is provided an ablation system comprising the handle of the first aspect (or the handle system of the second aspect).

[0034] The ablation system may include an ablation probe mountable within the handle housing. The ablation probe may include a catheter having one or more transparent coolant conduits configured to carry a flow of coolant. The coolant may be visible through an exposed portion of the catheter outside the housing during use. This may allow a user to verify that there are no air bubbles in the coolant. The microwave ablation system may further include a lead cable.

[0035] The catheter of the ablation probe may have a fiducial marker configured to indicate the position of the catheter within the working channel. The fiducial marker may include a distance scale configured to indicate the length of the exposed portion of the catheter tubing inserted into the handle. This may allow a user to precisely extend or retract the ablation probe from the housing to adjust the position of the ablation probe along the working channel. Additionally or alternatively, the fiducial marker may indicate when the catheter has reached the distal end of the working channel and / or is a particular distance from the distal end of the working channel. This may be particularly relevant for ablation procedures.

[0036] Those skilled in the art will understand that, except where mutually exclusive, features described in relation to any one of the above embodiments may be applied to any other embodiment.

[0037] Embodiments of the present invention will now be described, by way of example only, with reference to the accompanying drawings, in which: [Brief explanation of the drawings]

[0038] [Figure 1] FIG. 1 shows a schematic diagram of a microwave ablation system for use with an endoscope. [Figure 2] Figure 2a shows a side view of the ablation probe handle of the ablation system of Figure 1. Figures 2a-2f show the cross-sectional profile shape of the grip portion of the handle. [Figure 3] FIG. 3 shows an end view of the handle shown in FIG. [Figure 4] FIG. 4 shows a cross-sectional view corresponding to the view of FIG. 2a. [Figure 5] FIG. 5 shows the handle of FIGS. 2a-4 in use held by a right-handed grip. [Figure 6] FIG. 6 shows the handle of FIGS. 2a-4 in use held by a left-handed grip. [Figure 7] FIG. 7 shows a cross-sectional view of an ablation probe handle according to another embodiment. [Figure 8] FIG. 8 shows a side view of an ablation probe handle according to another embodiment. [Figure 9] FIG. 9 shows a cross-sectional view of the ablation probe handle of FIG. 8 with the two-part housing in a different configuration. [Figure 10] FIG. 10 shows a cross-sectional view of the ablation probe handle of FIG. 8 with the two-part housing in a different configuration. [Figure 11] FIG. 11 shows the ablation probe handle of FIGS. 8-10 in use. [Figure 12]FIG. 12 shows a schematic diagram of a manifold that may form part of the handle of the present application. [Figure 13] FIG. 13 shows a schematic diagram of another embodiment of the manifold of FIG. DETAILED DESCRIPTION OF THE INVENTION

[0039] FIG. 1 shows a schematic representation of a microwave ablation system 100 for use with an internal anatomical access system 102. The microwave ablation system 100 of the present disclosure is suitable for insertion into the body to reach a desired treatment site, such as a malignant tissue growth. To reach the desired treatment site, the ablation system includes an ablation probe 112 (which may also be referred to as a delivery device or system) suitable for insertion into a working channel of the internal anatomical access system 102. By internal anatomical access system, we mean any device that can be placed in a patient's anatomy, the device having a working channel for inserting an instrument to a desired location within the body. The internal anatomical access system may be an intraluminal delivery system configured to be delivered along a patient's anatomical lumen (e.g., the trachea and bronchial or esophageal pathways in the lungs). The ablation system 100 may be used to reach various disease sites within the body, for example, endoscopically or using an ENB (electromagnetic navigation bronchoscopy) system. The internal anatomical access system may comprise a bronchoscope or other type of endoscope or other type of internal navigation system required to reach any of the relevant parts of the body.

[0040] In the embodiments described herein, the delivery system 102 includes an endoscope 104 having a main working channel 106 that is insertable into a patient's body, as is known in the art. Only a portion of the length of the main working channel 106 is shown in FIG. 1 , but it may extend a suitable distance to access a desired location within the body, such as an ablation site in a lung. The endoscope includes a handle 108 that a user can grasp and manipulate. The delivery system 102 further includes an extension working channel 110 that is inserted along the main working channel of the endoscope 104 to access the ablation site. Various primary devices or tools, such as an ablation probe, can be inserted along the extension working channel 110.

[0041] The microwave ablation system 100 generally includes a microwave ablation probe 112, a handle 114, a lead cable 116, and a console unit 118. The microwave ablation probe 112 includes an applicator or antenna 120 located at its distal end that applies microwave radiation to surrounding tissue to cause localized heating and ablation. The ablation probe 112 further includes a catheter 122 configured to carry a microwave signal to the applicator. The catheter 122 may include a coaxial cable configured to transmit the microwave signal through the catheter tubing. The catheter is flexible so that it can be inserted and routed along the working channels 106, 110 of the delivery system 102 to reach the ablation site. Again, for clarity, only a portion of the length of the ablation probe is shown in FIG. 1 . The handle of the present application can be used in conjunction with any suitable ablation probe having a long, flexible catheter inserted along the working channel. The ablation probe may be, for example, one described in the applicant's earlier PCT application WO 2022 / 233938.

[0042] The term "catheter" generally refers to the elongated, flexible portion of the ablation probe that is inserted through the working channel. The catheter may include a feeder cable adapted to transmit microwave signals from the proximal end of the catheter to the applicator, and may further include a cooling circuit capable of pumping a coolant (e.g., water or saline) to control the surface temperature of the catheter at a safe level (e.g., below 43°C). The feeder cable may be a coaxial cable. The catheter may include a catheter tube within which the feeder cable is disposed.

[0043] The ablation probe extends between a proximal end and a distal end. In this application, the terms "distal" and "proximal" are relative to a user who manipulates the ablation probe and the treatment site at which the ablation probe is positioned in use, with the distal end of the ablation probe or working channel being the end closest to the treatment site and the proximal end being the end closest to the user. As used herein, the term "length" refers to the axis between the distal and proximal points of a component.

[0044] The ablation probe 112 and the extended working channel 110 are connected at their proximal ends to an ablation system handle 114, as described in more detail below. The handle 114 is adapted to be grasped by a user during use so that the extended working channel 110 and the ablation probe 112 can be manipulated and positioned at the desired ablation site.

[0045] The handle 114 is also connected to a lead cable 116. The lead cable 116 connects to the ablation probe catheter 122 in the handle 114 and is used to deliver microwaves and / or coolant. The lead cable is connected to a console unit 118, which may act as a control unit by which microwave ablation is controlled. The console unit 118 includes a microwave generator that may be used to generate a microwave signal at a desired frequency. The microwave signal propagates from the console unit 118 to the handle 114 via the lead cable and then along the catheter 122 of the ablation probe 112 to the applicator 120, where the microwave radiation is emitted. The console unit 118 may also provide a source of coolant that may be used to cool the ablation probe 112, and particularly the applicator 120. The ablation probe 112 may include one or more coolant channels (not shown) extending along the length of the catheter 122 that may form a coolant circuit configured to transport coolant to and from the applicator 120. The console unit 118 may include a pump (not shown) configured to provide coolant flow to and from the catheter 122 through the lead cable. While a single console unit 118 is shown in Figure 1 to provide both the microwave signal and the coolant, this configuration is not limited thereto. The lead cable may provide only the microwave signal or may include additional branches to connect to a separate coolant supply system distinct from the ablation console 118.

[0046] The lead cable may comprise a bundle of cables and / or other components, and may include any of the following: an RF power cable, a coolant tube that provides a coolant circuit to the ablation catheter, and / or a low-power electronic cable to provide power / communications from the ablation console to a PCB included in the handle.

[0047] Ablation system 100 is shown in FIG. 1 assembled for use, including lead cable 116 and extended working channel 110 coupled to handle 114, and catheter 122 of ablation probe 112 mounted to handle 114 and extending through extended working channel 110 and endoscope main working channel 106. Some or all of these components may be provided separately and assembled with other suitable components to form the illustrated ablation system 100. For example, handle 114 may be provided separately. Handle 114 may be provided with lead cable 116 pre-attached or integral to handle 114 so that it can then be attached to a suitable console unit 118. Handle 114 may be provided separately from extended working channel 122 (and other components of delivery system 102) and can be used with a variety of different types of working channels, as described below. Handle 114 may be provided separately from ablation probe 112, which may be coupled to handle 114 prior to use. Thus, a variety of different ablation probes can be used with the handle of the present application.

[0048] Further details of the handle 114 are shown in Figures 2a-6. Figure 2a is a side view showing the handle 114 in isolation, without other components of the ablation system 100. Figure 3 shows a corresponding end view. Figure 4 shows a cross-sectional view corresponding to that of Figure 2a, including the lead cable 116, catheter 122 of the ablation probe 112, and extended working channel 110. Figures 4 and 5 show examples of the handle 114 in use.

[0049] The handle 114 includes a housing 126. A portion of the housing is adapted to be grasped by a user when the handle 114 is in use. The handle 114 includes a lead cable connection interface 128 and a working channel connection interface 130 to which the lead cable 116 and the extended working channel 110 are connected, respectively.

[0050] The lead cable connection interface 128 in this embodiment comprises bores or holes 128a extending through the housing 126, into which the lead cables 116 are inserted and secured to a manifold 132. The manifold is disposed within the housing 126 of the handle 114 and is connected to the lead cables 116 and the ablation probe's power cable 122. The manifold thus provides a connection interface between the lead cables and the ablation probe, through which electrical connections are made to provide microwave propagation and fluid connections are provided to supply the ablation probe's coolant circuit. The handle thus provides an integrated power and coolant supply connection from the lead cables 116 to the ablation probe 112. In other embodiments, other types of connection interfaces for the lead cables 116 may be provided. In some embodiments, the manifold 132 may be absent, and the handle 114 provides different connections between the ablation probe 112 and the lead cables 116. In the illustrated embodiment, the lead cable 116 has a permanent, fixed connection to the handle 114; however, in other embodiments, it may be removably connected.

[0051] A portion of the length of the lead cable 116 extends along a portion of the length of the handle 114. In the embodiment described herein, the lead cable 116 extends within the body of the housing 126 along a portion of the length of the housing 126 (e.g., along the perforations 128a in the housing) and terminates at the manifold 132 (located at the proximal end of the handle). By extending along the length of the housing 126 in this manner, the lead cable 116 forms a "core" for the handle 114. Because the lead cable 116 is typically a relatively thick and heavy cable, this can provide increased strength for the handle 114 and simplify its design. In other embodiments, the lead cable 116 may extend along a portion of the length of the handle to form a core without being disposed inside the housing 126, as described below. In still other embodiments, the lead cable 116 may not extend within the body of the housing 126, but may be connected at the exterior wall of the housing 126.

[0052] The working channel connection interface 130 in this embodiment comprises a luer connection and includes a luer lock 132, through which the extended working channel 110 of the delivery system can be connected and disconnected. The use of a luer connection can provide interoperability with many different prior art delivery systems. Other types of connection interfaces may be provided for the working channel 110. The working channel 110 may be removably connected via the working channel interface 130 to allow for use with different delivery systems. The working channel connection interface may connect directly to the working channel, as shown schematically in FIG. 4, or may connect via an additional connection component, such as an adapter or other interface component that is part of the delivery system 102.

[0053] The handle 114 further includes a mount 134 adapted for mounting an ablation probe within the housing 126. As described in more detail below, the ablation probe (more specifically, the catheter 122 of the ablation probe 112) extends through the housing 126 so as to be mounted therein. The catheter 122 of the ablation probe 112 is positioned to extend from the outer wall of the housing at a location coincident with the working channel connection interface 130. When the extended working channel 110 is connected to the handle 114, this aligns the path of the catheter 122 with the working channel 110, allowing it to be inserted and routed along the working channel 110. The catheter 122 may be slidably mounted relative to the housing 126 (or a portion of the housing) so as to be movable proximally or distally along the length of the working channel 110, as described in more detail below.

[0054] The lead cable connection interface 128 and the working channel connection interface 130 each define a connection axis, i.e., lead cable connection axis X and working channel connection axis Y, respectively, as shown in FIG. 4 . The lead cable connection axis extends through the connection point of the lead cable 116 and defines axis X along the direction in which the lead cable connects or extends from a point on the outer surface of the housing 126 (e.g., axis X extends perpendicular to the surface of the housing at its connection boundary). Similarly, the working channel connection axis extends through the connection point of the extended working channel 110 and defines axis Y along the direction in which the working channel connects or extends from a point on the outer surface of the housing 126 (e.g., axis Y extends perpendicular to the surface of the housing at its connection boundary). The connection interfaces 128, 130 are arranged on the handle 114 such that the lead cable and working channel connection axes X, Y are offset from each other and can be parallel to each other, as shown in FIG. 4 . Moreover, as indicated by the arrows in Figure 4, the working channel may extend from the housing in the same direction relative to the housing as the lead cables. In other words, they both extend away from the housing 126 in a distal direction of the handle 114 (e.g., from each side of the housing distal to the handle). Although the working channel and the lead cables may be said to extend in the same direction away from the handle, it should be understood that the lead cables provide power to the handle, i.e., the direction of power flow is opposite to the direction of the lead cables extending from the handle as indicated by the arrows in Figure 4.

[0055] 4, the lead cable 116 and working channel 110 are offset from one another, rather than extending in the same direction away from the handle 114 and connecting from opposite ends along the same longitudinal axis of the handle. This connection arrangement helps to reconfigure the weight distribution of the lead cable 116 and handle 114 (e.g., compared to if they were in line) and may reduce or minimize loads at the delivery system (working channel) connection points. This may reduce the leverage effect that the heavy lead cable 116 has on the handle 114, allowing it to be more easily manipulated during use.

[0056] As described above, the handle includes an ablation probe mount 134 adapted to mount the ablation probe catheter 122 within the housing 126 so that it extends along the length of the working channel 110. The ablation probe mount 134 is configured to connect the ablation probe 112 at its proximal end to the lead cable 116 via the manifold 132. The proximal end of the catheter 122 is therefore secured to a fixed point on or within the housing 126. The ablation probe mount 134 is further configured to allow the catheter 122 to be relatively slidable within the housing 126 so that it can be inserted along the length of the working channel 110. The ablation probe mount may include a guide hole through which the catheter 122 can pass so that it is slidably mounted within the housing. The ablation probe mount 134 is configured to define an exposed portion 122a of the catheter 122 that extends outside the housing 126 and then extends back into the housing so that the catheter can be guided along the working channel connection axis Y. The catheter is configured to slide through housing 126, as indicated by the arrow in Figure 4. By adjusting the length of exposed portion 122a, the user can adjust the position of catheter 122 of ablation probe 112 in working channels 106, 110 and the position of applicator 120 at the distal tip of ablation probe 112 to the desired position for ablation.

[0057] As can be seen in Figure 4, exposed portion 122a of the catheter forms a loop on the outside of housing 126. This loop can be easily grasped and manipulated by the user, which is advantageous for providing tactile feedback to the user. The action of moving catheter 122 in and out of housing 126 via exposed portion 122a allows the user to directly manipulate the ablation probe and can be similar to existing methods of feeding devices into the working channel of an endoscope. This can help users manipulate the handle using skills they already have.

[0058] In some embodiments, catheter 122 may include one or more transparent coolant channels configured to carry a flow of coolant along the length of ablation probe 112, as described above. The exposed portion 122a of the catheter is further advantageous because it allows the coolant flow to be visible during use. For example, the user may be able to see any air bubbles in the cooling system in the exposed portion of the catheter, which would need to be removed to perform ablation.

[0059] In some embodiments, the ablation probe catheter 122 may have a fiducial marker configured to indicate the position of the catheter in the working channel. The fiducial marker may be used on the portion of the catheter that forms the exposed portion 122a so that it is visible during use. The fiducial marker may include a distance scale positioned to indicate the length of the exposed portion of the catheter tubing that is inserted into the handle. This may indicate the length of the catheter that has been inserted or withdrawn from the handle, and thus, how far the distal tip of the ablation probe has traveled. It may also include markers that specifically indicate when the distal tip of the catheter has reached the distal end of the working channel and / or when the catheter has extended a specific distance distally from the tip of the working channel.

[0060] In the embodiment described herein, the handle 114 further includes a catheter locking mechanism 136. The catheter locking mechanism 136 is movable between an unlocked state in which the catheter 122 is slidable relative to the housing 126 and an unlocked state in which the catheter 122 is not slidable relative to the housing 126. In this embodiment, the locking mechanism includes a rotation lock control. The rotation lock control includes a rotation wheel 136a that can be operated by a user to lock and release the catheter 122. In the example described above, the rotation wheel 136a may be attached to a screw so that when rotated, it moves along the length of the catheter 122 extending therethrough. The rotation lock control further includes an elastomeric material extending around the catheter that is compressed axially (e.g., along the length of the catheter) by the rotation wheel 136a as the rotation wheel 136a is rotated. The elastomeric material is constrained in this manner so that the compression causes the elastomeric material to expand radially, gripping the catheter 122 and providing resistance to sliding of the catheter 122 through the housing. Rotation of the wheel in the opposite direction allows expansion of the elastomeric material to release the catheter 122. It should be understood that this is just one example of a locking mechanism 136 that can be used to grip the catheter 122 and resist sliding relative to the housing. The locking mechanism 136 can be used to position the ablation probe at the desired ablation site and secure its position during ablation. Referring again to FIGS. 2a and 4, the housing 126 includes an elongated grip portion 138 suitable for gripping by a user. The grip portion 138 is shaped to be grippable by a user with one hand, as can be seen in FIGS. 5 and 6. The grip portion 138 is shaped to allow the user's arm to be gripped at 0-20 degrees of wrist extension and axial deflection when gripped by the user. This can provide an optimal and natural gripping position. The grip portion 138 can be grasped by a user with one hand (e.g., the non-dominant hand), while the other hand can be free to grasp the handle 108 of the endoscope 104 or adjust the position of the ablation probe.

[0061] The handle 114 includes one or more controls configured to control its operation. Such controls may include the locking mechanism 136 described above, but may also include other controls for controlling the position of the ablation probe or other aspects of the device's operation. The grip portion 138 is positioned on the handle 114 so that the one or more controls are spaced apart from one another along the length of the housing 126. The controls may be spaced from the grip portion 138 proximally of the handle. As can be seen in FIGS. 5 and 6, the controls are positioned relative to the grip portion 138 so that they can be operated by a user's thumb when the user's fingers are wrapped around the grip portion 138, without the user having to reposition their hand. The controls may be spaced from the grip portion by a distance D, e.g., 40-58 mm, that allows the user's thumb to reach the controls. The user's thumb reach is indicated by the dashed arc in FIG. 2a. By positioning the controls in this position, the controls can be reached by both left-handed and right-handed users, as can be seen in FIGS. 5 and 6.

[0062] The handle may include one or more visual indicators. The visual indicators may indicate the status of the ablation procedure. For example, the visual indicators may be one or more colored lights (e.g., LEDs) with different colors corresponding to different statuses involving the ablation procedure. The visual indicators may be in communication with control circuitry in the console unit and may indicate the status of the ablation procedure, such as whether the system is ready for ablation, whether ablation is working, or whether an error has occurred. The visual indicators may allow the user to visualize the progress of the ablation procedure without having to turn and look at the console unit 118. The visual indicators (colored lights) may be powered / controlled by a printed circuit board (PCB) in the handle. The PCB may also interface with a thermocouple contained in the ablation catheter. The PCB may also include an electrically erasable programmable read-only memory (EEPROM) chip to store / record information related to the procedure. The PCB may communicate with the ablation console via a lead cable.

[0063] The grip portion 138 defines a grip axis (labeled Z in FIGS. 2a-3 ) around which a user grips the handle 114. As can be seen in FIGS. 2a-3 , the grip axis Z may form a central longitudinal axis along the centerline of the portion of the housing that is gripped by the user. In the embodiment of FIGS. 2a-6 , the grip axis Z coincides with the lead cable connection axis X. However, as will be discussed below, this is not the case in all embodiments. The grip axis may more generally be parallel to the lead cable and working channel connection axes X and Y. The grip axis Z is offset relative to the working channel connection axis Y, as can be seen in FIGS. 2a-3 , so that they do not coincide with each other. Thus, the grip portion 138 is not concentric or collinear with the working channel axis Y. This may contribute to a comfortable grip and improved weight balance of the handle. Separating the grip axis Z from the working channel connection axis Y may create a fulcrum between the handle and the delivery system, allowing the handle to be more easily manipulated.

[0064] A cross-section of grip portion 138 of housing 126, taken through the plane designated AA in FIG. 2a, is shown in FIG. 2b. The grip portion has a non-circular cross-section. More specifically, the grip portion includes two flat portions 139a, 139b, each extending longitudinally along the length of grip portion 138. Flat portions 139a, 139b are located on opposite sides of grip portion 138, as shown. Flat portions 139a, 139b are joined by curved portions 139c, 139d. The cross-section thus has a generally elongated shape (e.g., having a minor axis M that is shorter than an orthogonal major axis N). In other embodiments, the grip portion may have another elongated cross-section, such as an oval or elliptical cross-section.

[0065] The cross-sectional shape of the grip portion is not perfectly cylindrical or circular, which facilitates gripping in the desired orientation. In the correct (desired) orientation, the flat portion can fit into the palm of the hand when gripped, and the curved portion accommodates the first interdigital space at one end of the grip portion and the wrap of the fingers at the other end of the grip portion. This helps guide the user to grip the handle in the correct orientation.

[0066] The major and minor axes of the cross section of the grip portion can be oriented relative to the rest of the handle housing to achieve a desired gripping orientation. The minor axis of the grip portion can be parallel to the plane in which the grip axis Z and the working channel connection axis Y are located. More specifically, the minor axis can be positioned in the same plane as the grip axis Z and the working channel connection axis Y, as can be seen in FIG. 3. This allows the user's hand to be oriented in a desired direction.

[0067] Further details of the cross-sectional geometry of grip portion 138 are shown in Figures 2c-2f. Flat portions 139a, 139b and curved portions 139c, 139d of the grip portion cross-sectional shape are labeled only in Figure 2c for clarity, but are also visible in Figures 2d-2f. As can be seen in each of Figures 2c-2f, the cross-sectional geometry of grip portion 138 is defined by two overlapping ellipses and two tangent lines connecting them.

[0068] The centers of the ellipses are offset from one another by a distance A, as shown in FIG. 2c. The centers of the ellipses are equidistantly spaced from the grip axis Z, such that the grip axis extends along the centerline of the grip portion 138. The offset of the ellipse centers results in a cross-section of the grip that is longer along its major axis compared to its minor axis, as described above. The major axis length is indicated by C in FIG. 2d, and the minor axis length is indicated by B. Length C is longer than length B, resulting in a non-circular profile of the grip portion. As can be seen in FIG. 2e (particularly in the enlarged view), flat portions 139a and 139b are each defined by a straight edge as a tangent connecting one ellipse to the other. The tangent defining the flat portion is parallel to the major axis of the grip portion. FIG. 2f illustrates the grip portion 138 mounted offset relative to the working channel connection axis Y. The offset distance D between the grip axis and the working channel connection axis is perpendicular to the center or midpoint of the offset between the two ellipses, which defines the center point of the mounting portion of the handle.

[0069] It should be understood that the cross-sectional geometry shown is one preferred embodiment and that other shapes, including a circular cross-section, are possible. In some embodiments, the grip portion may include a guide surface positioned to indicate which portion of the handle should be grasped by the user. The guide surface may extend across part or all of the grip portion 138. The guide surface may be formed by a portion of the housing having a different textured finish, or may be formed by a recessed area in the surface. This may guide the user to grasp the handle in the correct orientation.

[0070] The handle 114 may be rotatable about the working channel connection axis Y during use. A rotatable coupling may be provided between the working channel 110 and the housing (e.g., a rotatable Luer connection), or the working channel connection interface 130 may comprise a component that mates with the working channel 110 and is rotatably mounted to the housing 126. By allowing relative rotation between the handle 114 and the working channel 110, a user may be able to rotate the handle 114 about the working channel connection axis Y to hold it in a comfortable position. Moreover, as shown in FIGS. 5 and 6 , this may allow the handle to be comfortably held in either the left or right hand, without the need to provide different left- and right-handed devices for different users.

[0071] In the embodiment described herein, the lead cables 116 extend along the length of the grip portion 138 of the handle 114 to provide structural strength as described above. In the embodiment described herein, this is achieved by having the lead cable connection axis X coincide with the grip axis Z. Thus, by holding the grip portion 138 of the handle 114, the user effectively grasps around the lead cables 116.

[0072] Referring again to FIGS. 2a and 4, the housing 126 includes a recess 140 into which the working channel 110 is positioned when connected. The recess 140 comprises a reduced width portion of the length of the handle housing 126 and, in this embodiment, provides a location for the working channel connection interface 130. The recess 140 may provide space for connecting a delivery system to the side of the grip portion 126 of the handle 114, as can be seen in FIGS. 5 and 6. The recess 140 may advantageously provide space for a variety of differently shaped delivery systems, which may have a variety of differently shaped components at the proximal end of the working channel. This may allow a variety of different delivery systems to be connected to the handle, thereby enabling use with an array of existing systems. FIG. 7 shows a cross-section of another embodiment of the handle 114 of the present application. The handle 114 shown in FIG. 7 includes components corresponding to those of the handle 114 shown in FIGS. 2-6, which are correspondingly numbered.

[0073] The handle 114 of FIG. 7 differs from the embodiment of FIGS. 2a-6 in that it includes a sliding mechanism 142 that allows the connection point of the working channel 110 to slide relative to the housing 126 of the handle 114. In the embodiment of FIG. 7, the handle 114 includes a sliding component (e.g., carriage) 142a on which the working channel connection interface is disposed. The sliding component 142a is configured to slide along a track 142b relative to the housing 126. When fixedly held relative to the housing 126 (e.g., manually by the user or, more preferably, with the catheter locking mechanism 136), the sliding component 142a allows the working channel 110 to move independently relative to the housing 126 and, therefore, the catheter 122. This may allow the ablation probe 112 to be exposed from the extended working channel 110 while maintaining the position of the distal end of the ablation probe 112 at the ablation site. For example, ablation probe 112 can be positioned at a desired location while still within extended working channel 110. Once positioned at a desired location, the position of ablation probe 112 can be fixed relative to handle 114, and then sliding mechanism 142 can be operated to retract working channel 110 relative to handle 114, thereby extending the distal tip of ablation probe 112 from working channel 110 while leaving the distal tip in a fixed position.

[0074] Another embodiment of a handle 214 for an ablation probe is shown in FIGS. 8-10. The handle 214 can be used with the ablation system 100 and delivery system 102 shown in FIG. 1. FIG. 8 shows a side view corresponding to FIG. 2a, and FIGS. 9 and 10 show cross-sectional views corresponding to FIG. 4 in two different configurations. The handle 214 includes components corresponding to the above-described embodiments, and corresponding reference numerals are used. Matters described herein with respect to other embodiments can be used in combination with those shown in FIGS. 8-10, and vice versa, and therefore will not be described again. The handle 214 shown in FIGS. 8-10 includes a housing 226 including two portions, a first portion 226a and a second portion 226b. As shown in FIGS. 9 and 10, the first and second portions 226a, 226b are movable (e.g., slidable) relative to one another. The first portion of the housing 226 includes a lead cable connection interface 228. The second portion of the housing includes a working channel connection interface 230. The connection interfaces 228, 230 may be the same as those described in connection with Figures 2a-4, e.g., may have connection axes arranged in a similar configuration as offset connection axes, with the lead cables and working channels extending distally away from the housing as shown.

[0075] The ablation probe is secured within the first housing portion 226a. As shown in Figures 9 and 10, the ablation probe's catheter 222 is secured to a manifold 232, which is then connected to the lead cable 216 in a manner similar to that described above. Thus, the lead cable 216 and catheter 222 are secured relative to the first housing portion 226a. The second housing portion 226b is configured to provide a slidable connection to the catheter 222 such that the catheters are slidable relative to each other. The catheter 222 extends through the second housing 226b and is positioned to exit the second housing 226b at a point coincident with the working channel connection interface 230, thereby extending along the working channel similar to other embodiments described herein.

[0076] In this embodiment, the second housing portion 226b includes a moving column 226c along which the first housing portion 226a slides (translates) relative to the second housing portion 226b. Other configurations or mechanisms can be used to achieve the relative sliding movement between the portions of the housing 226.

[0077] Movement of the housing first portion 226a relative to the housing second portion 226b can move the ablation probe (i.e., catheter 222) relative to the working channel 210. This can be seen in FIGS. 9 and 10, where the housing first portion 226a is pushed down in the direction of the arrow in FIG. 10, while the housing second portion 226b remains stationary, pushing the catheter 222 along the working channel 210. This therefore results in movement of the catheter 222 similar to that produced by adjustment of the exposed loop portion 122a in the embodiment shown in FIGS. 2a-6. Referring again to FIG. 8, the housing 226 includes a grip portion 238 that can be grasped (and can have a similar shape) as described above and as shown in FIG. 11. The grip portion 238 is provided on the first portion of the housing 226a. The second portion 226b of the housing is thus held stationary (via its connection with the working channel 210) and the first portion 226a of the housing can be translated relative to the second portion of the housing to move the catheter 222 along the working channel 210.

[0078] Grip portion 238 of housing first portion 226a defines a grip axis Z similar to grip portion 138 described above. Grip axis Z in this embodiment extends along the central longitudinal axis of housing first portion 226a. As can be seen in FIG. 11, grip axis Z is offset from the connection axis Y of the working channel (and offset from the axis along which the catheter extends). This results in a similar offset grip position away from the axis of the working channel as described above. Grip axis Y may also be offset from or coincident with the connection axis of catheter 216, as shown in FIG. 11.

[0079] Referring again to FIG. 8, the housing 226 defines a recess 240 similar to the housing recess 140 shown in FIG. 2a. However, in this embodiment, the recess 240 provides a location for the lead cable connection interface 228. Similarly, to form the "core" of the handle, the lead cable 216 extends along the length of the handle 214, similar to what was described above with respect to FIGS. 2a-6. In the embodiment of FIGS. 8-11, however, the lead cable extends along the recess 240 on the outside of the housing 226, rather than within the housing as in FIG. 4. However, a similar effect is still achieved.

[0080] Referring again to FIG. 1 , in any of the embodiments described herein, the handle 114, 214 may form part of a handle system further comprising a lead cable-to-working channel connector 300. The connector 300 is positioned to connect the lead cable 116, 216 to the working channel 110, 210 at a point along the lead cable 116, 216 away from the housing 126, 226 of the handle 114, 214. This may provide a secondary attachment point on the lead cable for coupling to a delivery system. This may help provide additional structural support by using the strength of the lead cable to support the working channel. It may also help reduce leverage on the connection between the handle 114, 214 and the working channel 110, 210. FIGS. 12 and 13 show further details of a manifold 332, which may be used to provide electrical and fluid connections between the lead cable and the ablation probe catheter. As noted above, the ablation probe of the present application comprises an elongated, flexible catheter 322 including a catheter tube or shaft 350 having a power supply cable 352 disposed therein. The catheter further comprises a coolant tube 354 disposed to carry a flow of coolant along the length of the catheter 322 to an applicator (not shown in FIGS. 12 and 13) at its distal tip. A return flow of coolant flows along the space in the catheter shaft 350 (forming a coolant return channel) to return the coolant to the proximal end of the ablation probe.

[0081] The manifold 332 may include an RF connector 356 configured to form an electrical connection between the feed cable 352 and the lead cables. The RF connector 356 may include a coaxial connector (or an MCX connector (micro-coaxial connector)). The manifold may further include a seal 358 (e.g., an O-ring seal) positioned to form a seal between the RF connector 356 and the housing 332a or other components of the manifold.

[0082] The manifold 332 further includes a coolant inlet channel 360 that is fluidly connected to the coolant tubing 354 of the catheter 322 and to a coolant channel in the lead cable, forming a fluid connection therebetween. The manifold 332 further includes a coolant outlet channel 362 that is fluidly connected to a coolant return channel of the catheter 322 and to a coolant channel in the lead cable, forming a fluid connection therebetween, thereby allowing coolant to be returned to the ablation console. The inlet and outlet coolant channels 360, 362 may be located on either side of the RF connector 356, as shown in FIG. 12 .

[0083] The manifold 332 shown in FIG. 12 may have a minimum overall length L. This is advantageous for shortening the overall length of the power feed cable contained within the catheter. While the ablation probe must be long enough to reach the ablation site within the body, it is advantageous to shorten the length of the power feed cable to minimize electrical losses in the system and maximize power delivery to the emitting tip and, therefore, the size of the achievable ablation zone. The coolant inlet and outlet channels 360, 362 may be angled outward relative to the manifold housing (or centerline), as shown in FIG. 12. In an alternative embodiment shown in FIG. 13, the coolant inlet and outlet channels 360, 362 may be parallel to the manifold housing, e.g., parallel to the RF connector. This may allow the manifold length (and therefore the power feed cable length) to be further shortened.

[0084] The manifold described above may be used with any of the embodiments of the handles 114, 214 disclosed herein. The manifold may also be used with other ablation probe handles, such as those that do not have the offset arrangement of the connection interface described herein (i.e., the lead cable and working channel connection axes are parallel and not offset from one another, and the connection interface is arranged such that the working channel extends from the housing in the same direction as the lead cable when the working channel and lead cable are connected to the handle).

[0085] The handles and handle systems disclosed herein can be used with a variety of different delivery systems, not just the one shown in FIG. 1. The working channel interface is therefore more generally adapted to be connected to any suitable working channel along which the ablation probe can extend and which can be inserted into a patient's body to reach the ablation site. For example, separate main working channel 106 and extension working channel 110 as shown in FIG. 1 may not necessarily be required. There can be a single working channel or any other configuration of working channels, as long as they are connectable to a handle.

[0086] While the above embodiments include microwave ablation probes, the present application may be equally applicable to other types of ablation probes. The ablation probe may be configured to emit radiofrequency radiation to ablate tissue rather than microwave frequency radiation. Thus, microwave ablation system 102 may more generally be an ablation system configured to cause heating of tissue.

[0087] Various modifications will be apparent to those skilled in the art without departing from the scope of the claims. Any feature disclosed in connection with one embodiment may be used in combination with features of other embodiments. Although the appended claims are directed to particular combinations of features, the scope of the present disclosure should also be understood to include any novel feature or any novel combination of features explicitly or implicitly disclosed herein, or any generalization thereof, whether or not it relates to the same invention as claimed in any claim herein and whether or not it solves any or all of the same technical problems as the present invention.

[0088] Features that are described in the context of separate embodiments may also be provided in combination in a single embodiment. Conversely, various features that are, for brevity, described in the context of a single embodiment may also be provided separately or in any suitable subcombination. Applicant hereby notifies that new claims may be formulated to such features and / or combinations of such features during prosecution of this application or any further application derived therefrom.

[0089] For the sake of completeness it is also mentioned that the word "comprising" does not exclude other elements or steps, the words "a" or "an" do not exclude a plurality, a single processor or other unit may fulfill the functions of several means recited in the claims, and any reference signs in the claims shall not be construed as limiting the scope of the claims.

Claims

1. 1. An ablation probe handle for use with an ablation probe, the ablation probe being suitable for use with an internal anatomical structure access system, the ablation probe handle comprising: a housing adapted for gripping by a user; a lead cable connection interface defining a lead cable connection axis adapted for connection to a lead cable supplying a microwave source; an ablation probe mount adapted to mount an ablation probe catheter within said housing; and a working channel connection interface adapted for connection to a working channel of an internal anatomical structure access system, wherein the catheter of the ablation probe is positioned to extend from the housing along the working channel when the working channel is connected to the handle, and the working channel connection interface defines a working channel connection axis; the lead cable and working channel connection axes are parallel and offset from one another; and The connection interface is positioned such that when the working channel and the lead cable are connected to the handle, the working channel extends from the housing to the housing in the same direction as the lead cable.

2. 2. The ablation probe handle of claim 1, wherein the ablation probe mount is adapted to secure the catheter of the ablation probe within the housing such that an exposed portion of a length of the catheter is formed outside the housing, the exposed portion being proximal along the length of the catheter to a point where the catheter extends from the working channel connection interface, and the catheter is movable along the working channel by adjusting the length of the exposed portion outside the housing.

3. 3. An ablation probe handle according to claim 1 or 2, comprising: the housing comprising a first portion and a second portion; the lead cable connection interface is provided in the first portion of the housing; the ablation probe mount adapted to secure the catheter of the ablation probe relative to the first portion of the housing and to slidably secure the catheter relative to the second portion of the housing; the working channel connection interface is located in the second portion of the housing; and an ablation probe handle, wherein the first portion of the housing is slidable relative to the second portion of the housing, thereby allowing the catheter to slide along the length of the working channel.

4. 4. The ablation probe handle of claim 1, wherein the handle comprises a catheter locking mechanism movable between an unlocked state in which the catheter is slidable relative to the housing and an unlocked state in which the catheter is not slidable relative to the housing.

5. 5. The ablation probe handle of claim 1, wherein the handle comprises a sliding mechanism comprising a sliding component in which the working channel connection interface is positioned, the sliding component being slidable relative to the housing and allowing independent movement of the working channel relative to the catheter.

6. 6. An ablation probe handle according to any one of claims 1 to 5, wherein the housing comprises an elongated gripping portion adapted to be grasped by the user in one hand, optionally the gripping portion having a non-circular cross section and preferably comprising a surface having two flat portions joined by two curved portions.

7. 7. The ablation probe handle of claim 6, wherein the handle comprises one or more controls, and the one or more controls are spaced from the grip portion along the length of the housing, preferably proximally along the length of the housing.

8. 8. The ablation probe handle of claim 6 or claim 7, wherein the grip portion defines a grip axis about which the housing is grasped by the user, the grip axis being offset relative to the working channel connection axis.

9. 9. An ablation probe handle according to any one of claims 1 to 8, wherein the working channel connection interface is adapted to form a rotatable coupling with the working channel, whereby the handle is rotatable about the working channel connection axis during use.

10. An ablation probe handle according to any preceding claim, wherein a portion of the length of the lead cable extends along a portion of the length of the handle, preferably within or alongside a portion of the housing.

11. The ablation probe handle of any one of claims 1 to 10, wherein the housing includes a recess in which the working channel or lead cable connection interface is located.

12. 12. The ablation probe handle of claim 1, further comprising a manifold adapted for connection of the lead cables and the ablation probe to the catheter and configured to form an electrical connection when connected, optionally the lead cables being configured to carry a flow of coolant and the manifold being configured to form a fluid connection between the catheter and the lead cables when connected.

13. The manifold comprises: a) an RF connector, such as a coaxial connector, configured to form an electrical connection between a feed cable and the lead cables included in the catheter of the ablation probe; b) a coolant inflow channel positioned to provide a supply of coolant from the lead cable through the catheter of the ablation probe; and c) a coolant outflow channel positioned to carry a return flow of coolant from the catheter to the lead cable of the ablation probe; The ablation probe handle of claim 12 , comprising one or more of:

14. 14. A handle system comprising an ablation probe handle according to any one of claims 1 to 13, further comprising a connector capable of connecting the lead cable to the working channel at a point along the lead cable spaced from the housing.

15. 15. An ablation system comprising a handle or handle system according to any one of claims 3 to 14 depending directly or indirectly on claim 2, and an ablation probe mountable within the housing of the handle, comprising: a) the ablation probe comprises a catheter having one or more transparent coolant conduits configured to carry a flow of coolant, the coolant being visible through the exposed portion of the catheter outside the housing during use; and / or b) the catheter of the ablation probe having a fiducial marker configured to indicate the position of the catheter within the working channel. An ablation system that satisfies one or both of the above.

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