Abstract:
An electromagnetic surgical ablation system having a generator adapted to selectively provide surgical ablation energy to an ablation probe, and methods of operating same, are disclosed. The system includes a controller operatively coupled to the generator, and at least one tissue sensor probe operatively coupled to the controller. The at least one tissue sensor provides a tissue impedance measurement to the controller. A sensor probe may be designated a threshold probe adapted to sense when tissue is sufficiently ablated, or, a critical structure probe adapted to protect an adjacent anatomical structure from undesired ablation. During an electromagnetic tissue ablation procedure, the controller monitors tissue impedance to determine tissue status, to activate an indicator associated therewith, and, additionally or alternatively, to activate and deactivate the generator accordingly.

Description:
BACKGROUND 
       [0001]    1. Technical Field 
         [0002]    The present disclosure relates to systems and methods for providing energy to biological tissue and, more particularly, to apparatus and methods for sensing one or more properties of tissue at one or more locations during a microwave ablation procedure. 
         [0003]    2. Background of Related Art 
         [0004]    Energy-based tissue treatment is well known in the art. Various types of energy (e.g., electrical, ultrasonic, microwave, cryogenic, thermal, laser, etc.) are applied to tissue to achieve a desired result. Electrosurgery involves application of high radio frequency electrical current to a surgical site to cut, ablate, coagulate or seal tissue. In monopolar electrosurgery, a source or active electrode delivers radio frequency energy from the electrosurgical generator to the tissue and a return electrode carries the current back to the generator. In monopolar electrosurgery, the source electrode is typically part of the surgical instrument held by the surgeon and applied to the tissue to be treated. A patient return electrode is placed remotely from the active electrode to carry the current back to the generator. In tissue ablation electrosurgery, the radio frequency energy may be delivered to targeted tissue by an antenna or probe. 
         [0005]    There are several types of microwave antenna assemblies in use, e.g., monopole, dipole and helical, which may be used in tissue ablation applications. In monopole and dipole antenna assemblies, microwave energy generally radiates perpendicularly away from the axis of the conductor. Monopole antenna assemblies typically include a single, elongated conductor. A typical dipole antenna assembly includes two elongated conductors, which are linearly aligned and positioned end-to-end relative to one another with an electrical insulator placed therebetween. Helical antenna assemblies include a helically-shaped conductor connected to a ground plane. Helical antenna assemblies can operate in a number of modes including normal mode (broadside), in which the field radiated by the helix is maximum in a perpendicular plane to the helix axis, and axial mode (end fire), in which maximum radiation is along the helix axis. The tuning of a helical antenna assembly may be determined, at least in part, by the physical characteristics of the helical antenna element, e.g., the helix diameter, the pitch or distance between coils of the helix, and the position of the helix in relation to the probe assembly to which it is mounted. 
         [0006]    The typical microwave antenna has a long, thin inner conductor that extends along the longitudinal axis of the probe and is surrounded by a dielectric material and is further surrounded by an outer conductor around the dielectric material such that the outer conductor also extends along the axis of the probe. In another variation of the probe that provides for effective outward radiation of energy or heating, a portion or portions of the outer conductor can be selectively removed. This type of construction is typically referred to as a “leaky waveguide” or “leaky coaxial” antenna. Another variation on the microwave probe involves having the tip formed in a uniform spiral pattern, such as a helix, to provide the necessary configuration for effective radiation. This variation can be used to direct energy in a particular direction, e.g., perpendicular to the axis, in a forward direction (i.e., towards the distal end of the antenna), or combinations thereof. 
         [0007]    Invasive procedures and devices have been developed in which a microwave antenna probe may be either inserted directly into a point of treatment via a normal body orifice or percutaneously inserted. Such invasive procedures and devices potentially provide better temperature control of the tissue being treated. Because of the small difference between the temperature required for denaturing malignant cells and the temperature injurious to healthy cells, a known heating pattern and predictable temperature control is important so that heating is confined to the tissue to be treated. For instance, hyperthermia treatment at the threshold temperature of about 41.5° C. generally has little effect on most malignant growth of cells. However, at slightly elevated temperatures above the approximate range of 43° C. to 45° C., thermal damage to most types of normal cells is routinely observed. Accordingly, great care must be taken not to exceed these temperatures in healthy tissue, 
         [0008]    In the case of tissue ablation, a high radio frequency electrical current in the range of about 500 MHz to about 10 GHz is applied to a targeted tissue site to create an ablation volume, which may have a particular size and shape. Ablation volume is correlated to antenna design, antenna tuning, antenna impedance and tissue impedance. Tissue impedance may change during an ablation procedure due to a number of factors, e.g., tissue denaturization or desiccation occurring from the absorption of microwave energy by tissue. Changes in tissue impedance may cause an impedance mismatch between the probe and tissue, which may affect delivery of microwave ablation energy to targeted tissue. The temperature and/or impedance of targeted tissue, and of non-targeted tissue and adjacent anatomical structures, may change at a varying rates which may be greater, or less than, expected rates. A surgeon may need to perform an ablation procedure in an incremental fashion in order to avoid exposing targeted tissue and/or adjacent tissue to excessive temperatures and/or denaturation. In certain circumstances, a surgeon may need to rely on experience and/or published ablation probe parameters to determine an appropriate ablation protocol (e.g., ablation time, ablation power level, and the like) for a particular patient. 
       SUMMARY 
       [0009]    The present disclosure is directed to an electromagnetic surgical ablation system that includes at least one tissue sensor probe that is adapted to sense a tissue property, e.g., tissue impedance, at or near an ablation surgical site. Also disclosed is a controller module which may include a sensor interface having at least one sensor input adapted to receive a sensor signal from the at least one tissue sensor probe. Additionally or alternatively, one or more sensor interfaces may be provided by the controller module. The disclosed sensor interface may include an impedance measurement circuit that is adapted to perform a conversion of a raw signal, which may be received from the at least one tissue sensor probe, into an impedance measurement suitable for processing by a processer included within the controller. 
         [0010]    The disclosed surgical ablation system may include a source of microwave ablation energy, such as generator, that is responsive to a control signal generated by the control module. The one or more tissue sensor probes, the controller, and the generator function cooperatively to enable a surgeon to monitor one or more tissue properties at, or adjacent to, an ablation surgical site. Additionally or alternatively, the described arrangement may enable the automatic control, activation, and/or deactivation of ablation energy applied to tissue to enable precise control over the ablation size and/or volume created during an ablation procedure. 
         [0011]    In addition, the present disclosure provides an electromagnetic surgical ablation system having a generator adapted to selectively provide surgical ablation energy to an ablation probe. The ablation probe is operably coupled to the generator and adapted to receive ablation energy therefrom, and to deliver said ablation energy to targeted tissue, e.g., a tumor, polyp, or necrotic lesion. The disclosed system includes a controller operatively coupled to the generator, the controller including at least one processor, a memory operatively coupled to the processor, a sensor interface circuit operatively coupled to the processor and adapted to receive a one or more impedance sensor signals from one or more tissue sensor probes. Additionally or alternatively, a tissue sensor probe may include additional sensor, such as without limitation, a temperature sensor. In such an embodiment, the sensor interface circuit may include a temperature sensor circuit operatively coupled to the processor and adapted to receive a temperature sensor signal from a tissue sensor probe. 
         [0012]    In one aspect, a system in accordance with the present disclosure may enable a surgeon to place one or more tissue sensor probes around a targeted ablation region, and/or between a targeted ablation region and an adjacent anatomical structure. During an ablation procedure, the controller may monitor the one or more sensors to track the progress of the ablation region as tissue is “cooked”, based at least in part upon an impedance change detected at the one or more probe locations. In an embodiment, a feedback signal may be provided to the surgeon, e.g., a visual, audible, and/or tactile indication, such that a surgeon may follow the ablation region formation in real-time or in near-real-time. Each probe may be positioned such that targeted tissue may be monitored at various locations around, and/or distances from, an ablation probe being utilized to deliver ablation energy to tissue. 
         [0013]    A tissue sensor probe may be identified (e.g., assigned or tagged) and/or adapted as a “threshold” probe or a “critical structure” tag. It is envisioned that a threshold tag may be configured to sense when the tissue associated therewith has reach an ablation threshold, e.g., the point at which the desired degree of desiccation has occurred. As tissue associated with a given probe has reached the desired ablation state, an indicator associated with the sensor may be activated. When a plurality of threshold probes are utilized, a surgeon may recognize when an ablation procedure is completed by noting when all, or a sufficient number of, indicators associated with the various probes have been activated. In an embodiment, the controller may automatically deactivate an ablation generator when all, or a sufficient number of, threshold probes have reached a predetermined threshold. 
         [0014]    A probe identified as a “critical structure” probe may be configured to activate an indicator, which may be an alarm indicator, when tissue associated therewith is about to, but has not yet, received ablation energy in excess of a predetermined safety threshold. Additionally or alternatively, the disclosed system may be configured to automatically deactivate an ablation generator when a predetermined number (e.g., one or more) of indicators associated with a critical structure probe have been activated. While it is contemplated that a critical structure probe may be positioned between an operative field and an adjacent critical anatomical structure, it should be understood that the present disclosure is in no way limited to such use and that the described probes and features may be advantageously utilized in any combination for any purpose. 
         [0015]    Also disclosed is a method of operating an electromagnetic surgical ablation system. The disclosed method includes the steps of activating an electrosurgical ablation generator to deliver ablation energy to tissue and sensing a tissue impedance parameter from at least one tissue sensing probe, which may be inserted into tissue. A determination is made as to whether a sensed tissue impedance parameter exceeds a predetermined tissue impedance parameter threshold. In response to a determination that a sensed tissue impedance parameter exceeds a predetermined tissue impedance parameter threshold, an action is performed, e.g., the electrosurgical ablation generator is deactivated and/or an indication is presented. 
         [0016]    The present disclosure also provides a computer-readable medium storing a set of programmable instructions configured for being executed by at least one processor for performing a method of performing microwave tissue ablation in response to monitored tissue temperature and/or monitored tissue dielectric properties in accordance with the present disclosure. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0017]    The above and other aspects, features, and advantages of the present disclosure will become more apparent in light of the following detailed description when taken in conjunction with the accompanying drawings in which: 
           [0018]      FIG. 1  shows a diagram of a microwave ablation system having an electromagnetic surgical ablation probe and at least one tissue sensor probe in accordance with the present disclosure; 
           [0019]      FIG. 2  shows a block diagram of a microwave ablation system having an electromagnetic surgical ablation probe and at least one tissue sensor probe in accordance with the present disclosure; 
           [0020]      FIG. 3  is a perspective view of a tissue sensor probe in accordance with the present disclosure; 
           [0021]      FIG. 4  is a side, cutaway view of a tissue sensor probe in accordance with the present disclosure; 
           [0022]      FIG. 5  is a flowchart showing a method of operation of microwave ablation system having at least one tissue sensing probe in accordance with the present disclosure; and 
           [0023]      FIG. 6  illustrates a relationship between time, an impedance sensed by a first tissue probe, and an impedance sensed by a second tissue probe in accordance with the present disclosure. 
       
    
    
     DETAILED DESCRIPTION 
       [0024]    Particular embodiments of the present disclosure are described hereinbelow with reference to the accompanying drawings; however, it is to be understood that the disclosed embodiments are merely examples of the disclosure, which may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present disclosure in virtually any appropriately detailed structure. 
         [0025]    In the drawings and in the descriptions that follow, the term “proximal,” as is traditional, shall refer to the end of the instrument that is closer to the user, while the term “distal” shall refer to the end that is farther from the user. 
         [0026]      FIG. 1  shows an embodiment of a microwave ablation system  10  in accordance with the present disclosure. The microwave ablation system  10  includes an electromagnetic surgical ablation probe  100  having a having a tapered distal tip  120  and a feed point  122 . The ablation probe  100  is operably connected by a cable  15  to connector  16 , which further operably connects probe  100  to a generator assembly  20 . Generator assembly  20  may be a source of ablation energy, e.g., microwave or RF energy in the range of about 915 MHz to about 10 GHz. The disclosed system  10  includes one or more tissue sensor probes  200  that are adapted to sense one or more operative parameters, e.g., a tissue impedance. The tissue sensor probe  200  is operably connected by a cable  14  to a connector  18 , which further operably connects tissue sensor probe  200  to a controller assembly  30 . An actuator  40  is operably coupled to the controller to enable a user, e.g., a surgeon, to selectively activate and de-activate the delivery of ablation energy to patient tissue. Controller  30  is operably coupled to generator  20  to enable communication therebetween, such as without limitation, a control signal and/or a status signal. 
         [0027]    In more detail,  FIG. 2  illustrates a functional block diagram of an ablation system  10  in accordance with the present disclosure. The system  10  includes a controller  30  that includes one or more processors  31  operatively coupled to memory  32 , storage device  33 , sensor interface  34 , and user interface  35 . Processor  31  is configured to execute a set of programmed instructions for performing a method of microwave ablation as disclosed herein. Memory  32  and/or storage device may include any suitable memory device, including without limitation semiconductor memory (random-access memory, read-only memory, flash memory), hard disk, optical storage (e.g., CD-ROM, DVD-RAM, etc.), USB memory stick, and the like. 
         [0028]    Controller  30  includes an actuator interface  36  that is adapted to facilitate operative coupling with actuator  40  and/or a generator interface  37  that is adapted to facilitate operative coupling with generator  20 . Actuator  40  may be any suitable actuator, such as without limitation, a footswitch, a handswitch (which may be mounted on a probe  100  and/or a tissue sensor probe  200 ), an orally-activated switch (e.g., a bite-activated switch and/or a breath-actuated switch), and the like. The processor  31 , memory  32 , storage device  33 , sensor interface  34 , actuator interface  36  and/or generator interface  37  may be separate components or may be integrated, such as in one or more integrated circuits. The various components in the controller  30  are coupled by one or more communication buses or signal lines  38 . Memory  30  and/or storage device  33  may include a set of executable instructions for performing a method of microwave ablation as described herein. One or more elements of ablation system  10  may be coupled using a hard-wired connection (e.g., copper wire and/or fiber optic media) and/or a wireless link. During use, the one or more tissue sensor probe  200  may be positioned in tissue T in proximity to probe  100  to obtain one or more tissue parameter(s), e.g., tissue impedance. 
         [0029]    User interface  35  may include any suitable form of visual, audible, or tactile user interface elements, including without limitation, a graphic display panel (e.g., LCD, LED, OLED plasma, gas-discharge display, an the like), touchscreen, keypad, pushbutton, switch, lamp, annunciator, speaker, haptic feedback device, and so forth. 
         [0030]    As shown in  FIG. 2 , and by way of example only, an ablation probe  100  is inserted into tissue T for use. A tissue sensor probe  200  is inserted into tissue T in a position generally adjacent to probe  200 . Another tissue sensor probe  200 ′ is inserted into tissue T at a position further from probe  100 . Yet a third tissue sensor probe  200 ″ is inserted into tissue T at a position generally between probe  100  and a critical anatomical structure CS. During use, ablation energy from probe  100  is delivered into tissue T to effectuation ablation of at least a part of tissue T. Denaturation of tissue T proceeds generally outwardly from feed point  122 . As the volume of denatured (ablated) tissue expands, an impedance boundary expands in a corresponding manner. 
         [0031]    It has been observed that during an initial phase of an ablation procedure, tissue impedance with remain relatively constant. As tissue approaches denaturation (e.g., as tissue becomes “cooked”), impedance tends to rise rapidly. By sensing the impedance at one or more points surrounding the ablation probe  100 , the formation of the ablated volume of tissue may be accurately monitored. In turn, the delivery of ablation energy may be controlled in response to the one or more impedance measurements obtained from the surrounding tissue. Thus, a surgeon may define a desired ablation region by deliberately positioning one or more tissue sensor probes  200  at or near the outer boundaries of the desired region. As each probe  200  senses a rise in impedance (which may signify tissue denaturation has occurred), a corresponding indication may be presented to a user (e.g., a surgeon) that ablation of the tissue corresponding to the probe has completed. An indication may be presented via user interface  35 . The defined ablation volume is deemed fully ablated once each designated tissue probe  200  has sensed an impedance rise corresponding to denaturation. An “ablation complete” indication may then be presented to the user, or, additionally or alternatively, the generator  20  may be automatically deactivated. In this manner, the ablation region may be precisely controlled with greatly reduced risk of over-ablation and/or excessive charring of tissue or injuring critical structures. 
         [0032]    The tissue probe(s)  200  may be designated as a threshold probe or a critical structure probe. One or more threshold probes may be used to define an ablation volume by deliberate placement in tissue by a surgeon, as described hereinabove. The one or more threshold probe(s) may be grouped to define a threshold group, whereby an ablation complete status is established when each threshold probe in a group has sensed an impedance rise corresponding to tissue denaturation. In contrast, a critical structure probe may be used to recognize a pre-denaturation state of tissue, such as without limitation, an initial slight or gradual rise in impedance which may precede a more pronounced or rapid rise in impedance associated with tissue denaturation. In an embodiment, if any one critical structure probe senses pre-denaturation, an indicator may be presented to the user and/or generator  200  deactivated. In this manner, undesired ablation of one or more critical anatomical structures at or near the ablation site may be prevented. 
         [0033]    A graph illustrating a relationship between sensor position, ablation time, and tissue impedance is presented in  FIG. 6 , wherein a first impedance curve  405  corresponding to a first tissue sensor probe  200 , and a second impedance curve  410  corresponding to a second tissue sensor probe  200 ′, are shown. Initially, as ablation energy is first delivered to tissue, both tissue sensor probes  200  and  200 ′ indicate a relatively constant impedance value  401 . As ablation time t progresses, tissue surrounding first tissue sensor probe  200  begins to denature, as illustrated by a rise in impedance  406 . As ablation continues, the volume of denatured tissue expands, and eventually, reaches second tissue sensor probe  200 ′, as illustrated by a second rise in impedance  411 . Denaturation may be indicated by, e.g., an absolute rise in impedance, a change in impedance from an initial impedance value, and/or rate of change of impedance exceeding a predetermined rate. 
         [0034]    Designation of a tissue probe  200  as a threshold probe or a critical structure probe may be accomplished manually by, e.g., a user entering the appropriate designation via user interface  35 . Additionally or alternatively, a tissue probe  200  may include an identifier (not explicitly shown) that identifies to controller  30  the probe as a threshold probe, a critical structure probe, or a universal probe which may function as either a threshold probe or a critical structure probe. The identifier may include, without limitation, an RFID tag, a semiconductor memory device (e.g., ROM, EEPROM, NAND or NOR flash memory), an encoded electrical component (encoded resistor value), a mechanical identifier (e.g., physically encoded connector member), an optical identifier (e.g., a barcode) and the like. In an embodiment, a user entry may override an identifier-defined designation of a probe  200 . 
         [0035]    A tissue sensor probe  200  in accordance with an embodiment of the present disclosure is now described with reference to  FIGS. 3 and 4 . The disclosed tissue sensor probe  200  includes an elongated shaft  210  having a proximal end  213  and a distal end  211 . A tapered tip  220  may be disposed at a distal end  211  of the probe  200  to facilitate the insertion of probe  200  into tissue. As shown, tapered tip  220  has a generally conical shape; however, any suitable tip shape may be utilized. A pair of electrodes  222 ,  224  are disposed on an exterior portion of the shaft  210 . As shown, electrodes  222 ,  224  are substantially annular in shape and disposed coaxially about the shaft; however, other electrode arrangements are contemplated within the scope of the present invention, including without limitation, longitudinal electrodes, helical electrodes, dot-shapes electrodes, and so forth. Electrodes  222 ,  224  may be formed from any suitable biocompatible and electrically conductive material, such as without limitation, stainless steel. In an embodiment, electrodes  222 ,  224  are disposed generally toward a distal end of the shaft  210 ; however, it is to be understood that either or both electrodes  222 ,  224  may be positioned at other locations along shaft  210 . 
         [0036]    The probe  200  includes a pair of conductors  226 ,  228  that are configured to place electrodes  222 ,  224 , respectively, in electrical communication with controller  30  via cable  14  and/or connector  18 . A distal end of conductor  226  is electrically coupled to electrode  222 . A distal end of conductor  228  is electrically coupled to electrode  224 . The connection between conductors  226 ,  228  to electrodes  222 ,  224 , respectively, may be formed by any suitable manner of electrical or electromechanical connection, including without limitation soldering, brazing, welding, crimping, and/or threaded coupling. Cable  14  extends from a proximal end  213  of shaft  210 , and may be supported by a strain relief  214 . 
         [0037]    Shaft  210  and electrodes  222 ,  224  may be formed by any suitable manner of manufacture. In an embodiment, shaft  210  may be formed by injection overmolding. By way of example only, shaft  210  may be formed from a high strength, electrically insulating material, e.g., fiber-reinforced polymer, fiberglass resin composite, long strand glass-filled nylon, and the like. During use, probe  200  may be inserted into tissue, placing electrodes  222 ,  244  into electrical communication with tissue thereby enabling sensor interface  34 , and controller  30  generally, to obtain an impedance measurement thereof. 
         [0038]    Turning to  FIG. 5 , a method  300  of operating an electromagnetic surgical ablation system having an ablation probe  100 , and one or more tissue sensor probe(s)  200 , is shown. The disclosed method begins in step  305  wherein one or more initializations may be performed, e.g., power-on self test (POST), memory allocation, input/output (I/O) initialization, and the like. In step  310 , each of the tissue sensor probes to be used in the ablation procedure is designated as a threshold probe or a critical structure probe. In an embodiment, the user (e.g., a surgeon or an assisting practitioner) may manually input a corresponding designation for each tissue sensor probe. Additionally or alternatively, the tissue sensor probe may be automatically identified by as identifier included within the probe  200  and sensed by controller  30  and/or sensor interface  34  as described hereinabove. 
         [0039]    A threshold value for each tissue sensor probe  200  may be established. In one embodiment, a threshold value for a threshold tissue sensor may differ from a threshold value for a critical structure tissue sensor. A threshold may be an absolute threshold, e.g., exceeding a fixed impedance value; a relative threshold, e.g., exceeding a predetermined change in impedance; or a rate threshold, e.g., where the rate of impedance change exceeds a predetermined rate. Other thresholds are contemplated within the scope of the present disclosure, including without limitation, spectral-based thresholds, wavelet-based thresholds, and impedance contour recognition thresholds. 
         [0040]    The total number of tissue sensor probes designated for use during an ablation procedure may be represented as n. In step  315 , the one or more tissue sensor probes are inserted into tissue in accordance with surgical requirements. In particular, a threshold probe is placed at or near an outer boundary of the desired ablation region, while a critical structure probe is positioned between the intended ablation region and a critical anatomical structure to be protected. In addition, an ablation probe  100  is positioned or inserted into tissue, e.g., the ablation site. 
         [0041]    Once the ablation probe  100  and the one or more tissue sensor probes  200  have been positioned, the ablation generator  20  is activated in step  320  to cause electromagnetic ablation energy to be delivered to tissue. Generally, activation of generator  20  will be effectuated in response to engagement of actuator  40 . During the ablation delivery process, the impedance of each designated tissue sensor probe is monitored. In step  325  a monitoring loop is established wherein a tissue sensor probe counter x is initialized, e.g., set to address the first of the currently-utilized one or more tissue sensor probes  200 , which may be expressed a probe(x). In step  300 , an impedance value of the currently-addressed tissue sensor probe  200 , which may be expressed as Zprobe(x), is compared to a corresponding threshold value. If Zprobe(x) does not exceed a corresponding threshold value, the method proceeds to step  335  wherein it is determined whether the generator is to be deactivated, e.g., the user has released actuator  40 . If in step  335  it is determined that the generator  20  is to be deactivated, in step  365  the generator is deactivated and the process concludes with step  370 . 
         [0042]    If, in step  335  it is determined that the generator  20  is to remain activated, in step  355  the tissue sensor probe counter is increment to address the next tissue sensor probe in use and in step  360 , the tissue sensor probe counter is compared to the total number of tissue sensor probes designated for use. If in step  360  it is determined that the tissue sensor probe counter exceeds the total number of tissue sensor probes designated for use, the tissue sensor probe counter x is re-initialized in step  325 , otherwise, the method continues with step  330  wherein the impedance value of a subsequent tissue sensor probe  200  is evaluated. 
         [0043]    If, in step  330 , it is determined that Zprobe(x) exceeds a corresponding threshold value, then in step  340  it is determined whether the currently-addressed tissue sensor probe, i.e., probe(x), is designated as a threshold probe or a critical structure probe. If probe(x) is a critical structure probe, then in step  350  an alarm indication is presented to the user, and step  365  is performed wherein the generator  20  is deactivated (which may help reduce possible damage to the critical structure corresponding to probe(x). If probe(x) is a threshold probe, then a status indication is presented to the user in step  345  (to indicate ablation progress status) and the method proceeds to step  335  as described hereinabove. In an embodiment, an additional test may be performed wherein it is determined whether all threshold probes currently in use, and/or all threshold probes within a designated probe group, have exceeded the corresponding threshold thereof, and, if so, continue with step  265  to deactivate generator  20 . 
         [0044]    It is to be understood that the steps of the method provided herein may be performed in combination and/or in a different order than presented herein without departing from the scope and spirit of the present disclosure. 
         [0045]    The described embodiments of the present disclosure are intended to be illustrative rather than restrictive, and are not intended to represent every embodiment of the present disclosure. Further variations of the above-disclosed embodiments and other features and functions, or alternatives thereof, may be made or desirably combined into many other different systems or applications without departing from the spirit or scope of the disclosure as set forth in the following claims both literally and in equivalents recognized in law. The claims can encompass embodiments in hardware, software, firmware, microcode, or a combination thereof.