Apparatus for manipulating an elongated medical member

Abstract

An apparatus (100) for manipulating a remote elongated medical member, the apparatus (100) comprising: a control unit (101) comprising a transmitter (101a); a local elongated medical member (1001) configured to be manipulated by a user of the apparatus (100); a sensing unit (1003) configured to sense a first parameter of the local elongated medical member (1001); and a haptic feedback unit (105) configured to provide haptic feedback to the user of the apparatus (100) based on the first parameter.

Description

[0001] UAB Inovatyvi medicina 30A-166 907

[0002] - 1 -

[0003] APPARATUS FOR MANIPULATING AN ELONGATED MEDICAL MEMBER

[0004] FIELD OF THE INVENTION

[0005] The present invention generally relates to an apparatus for manipulating a remote elongated medical member comprising a control unit, a local elongated medical member, a gripping unit, a sensing unit, a haptic feedback unit, a device and a user display.

[0006] BACKGROUND TO THE INVENTION

[0007] Endovascular specialists (for example (endo-)vascular surgeons, (interventional) cardiologists, (interventional) radiologists etc.) train, practice and develop intuitive skills to handle surgical tools. The mental imagery of skills of physicians also evolves by correlating their actions and responses of surgical tools within the human anatomy. An endovascular surgeon is generally guided by two senses: visual feedback from the imaging devices and reaction force feedback via the tool. Perception-action- visualization abilities of surgeons are fine-tuned to a level where their surgical decisions are made even without observing their hand gestures.

[0008] Currently, existing robotic systems are focused exclusively on imaging feedback, but have ignored the other source of information: tactile feedback from surgical tools. Instrument controls using a joystick and a PC interface are closer to videogame controllers than control of surgical instruments and leave vascular surgeons with less feedback information which is available performing the procedure manually.

[0009] The inventors have realized that existing vascular robotic systems are controlled via a computer interface, in contrast to what vascular surgeons are trained to do with, for example, guidewires and catheters.

[0010] There is therefore a need for improvements of (endo-) vascular robotic systems.

[0011] SUMMARY OF THE INVENTION

[0012] The invention is set out in the independent claim. Preferred embodiments of the invention are set out in the dependent claims. UAB Inovatyvi medicina 30A-166 907

[0013] - 2 -

[0014] According to a first aspect, we describe an apparatus for manipulating a remote elongated medical member, the apparatus comprising: a control unit comprising a transmitter; a local elongated medical member configured to be manipulated by a user of the apparatus; a sensing unit configured to sense a first parameter of the local elongated medical member; and a haptic feedback unit configured to provide haptic feedback to the user of the apparatus based on the first parameter.

[0015] The apparatus may be of any suitable design and / or shape as long as it comprises the above-mentioned features. This may allow for the apparatus to be modified to the situation and / or environment said apparatus is in.

[0016] In some examples, the local and / or remote elongated members may be a catheter, a stent, a catheter balloon, a stent balloon, a thrombectomy device, a coil, a glue system, a guidewire or any other instrument that may be particularly useful in the field of endovascular systems. In some examples, the local and / or remote elongated members may not be the same. That is to say, the remote member may be, for example, a catheter and the local member may be, for example, a stent.

[0017] The control unit may be located at a location remote from the remote elongated medical member and be coupled to the apparatus and / or control unit via wired and / or wireless means. The local elongated medical member is configured to be manipulated by a human. In some examples, the local elongated medical member is a replica of the remote elongated medical member, or is a representation of the remote elongated medical member. This may allow for the human to have a better understanding of the feel of the remote elongated medical member as the local elongated medical member comprises, preferably, the same materials and dimensions as the remote elongated medical member.

[0018] The sensing unit is preferably configured to sense a movement of the local elongated medical member. The sensing unit may comprise mechanical and / or magnetic and / or optical means in order to sense this movement. This movement may be sensed in the longitudinal axis of the elongated medical member and / or the rotational axis of the elongated medical member. Each local elongated medical member is preferably coupled to a sensing unit. Each sensing unit is preferably coupled to a gripping unit of the apparatus, as is described in more detail below. UAB Inovatyvi medicina 30A-166 907

[0019] - 3 -

[0020] The haptic feedback unit may allow for the user of the apparatus to feel what is happening at the remote member and realize if the movement of the remote elongated medical member has been blocked, for example, as the haptic feedback may be suddenly greatly increased.

[0021] In some examples, the apparatus further comprises a device configured to enable and disable the transmitter. This device is described in more detail below.

[0022] In some examples, the apparatus further comprises a user display configured to display the first parameter of the local elongated medical member and / or a second parameter of the remote elongated medical member. The user display may display the first and / or second parameter, which may relate to a distance in a predetermined direction the respective member has been moved from a zero point and / or a rotation angle of the local / remote elongated member from a predetermined zero point and / or a force being exerted on the local / remote elongated member and / or a rate of change of speed and / or angle of the local / remote elongated member as it is being rotated by the user and / or a relative distance between a plurality of local / remote elongated medical members and / or information about the local / remote elongated medical member such as, for example, a diameter and / or a name and / or a size, and / or any other suitable state that can be displayed to the user. This may allow the user to determine a state of the local / remote elongated member and get a better idea of what the user has done so far and may help the user plan future steps. This also may allow for the user to see if there are any problems with the local / remote elongated member and / or gripping unit and / or sensing unit and / or haptic feedback unit if the user recognizes that the states / parameters on the display do not match up with what they have done.

[0023] In some examples, the local elongated medical member is configured to be manipulated in two axes of movement, in particular wherein the axes are a longitudinal axis of the local elongated medical member and a rotational axis around the longitudinal axis of the local elongated medical member. The axes may be any other suitable axis. This may allow for the local elongated medical member to be moved in a manner similar to that as if the user was at the location of the remote elongated medical member. This may allow for a user to gain a more realistic feel of the procedure without being physically present at the location. UAB Inovatyvi medicina 30A-166 907

[0024] - 4 -

[0025] In some examples, the first parameter comprises a distance the local elongated medical member has been manipulated and / or a rotational angle through which the local elongated medical member has been manipulated, from a predetermined position. This may allow for the user to have a better idea of how they have manipulated the local member, and how this translates to the remote member.

[0026] In some examples, the first parameter comprises a force exerted on the local elongated medical member. This may allow for the user to have a better idea of how they have manipulated the local member, and how this translates to the remote member. This may also allow the user to know if the local elongated medical member is reaching a limit of movement / force, thereby extending the lifetime of the local member, and also protecting it from damage.

[0027] In some examples, the apparatus further comprises a gripping unit configured to grip the local elongated medical member, wherein the gripping unit is moveable and / or rotatable based on the manipulation of the local elongated medical member. The local elongated member is preferably fixed with respect to the gripping unit, and the gripping unit is coupled to a sensing unit and / or a linear drive and / or a rotational drive to allow for the movement and rotation of the gripping unit.

[0028] The gripping unit may be of any suitable construction configured to grip the local elongated medical member. This may reduce the chance of the local elongated medical member sli ppi ng / fa Hing out from the gripping unit, and improve patient safety. In some examples, the gripping unit is moveable and / or rotatable based on the received second control signal. The local elongated member is preferably fixed with respect to the gripping unit, and the gripping unit is coupled to a sensing unit and / or a linear drive and / or a rotational drive to allow for the movement and rotation of the gripping unit.

[0029] In some examples, the transmitter is configured to transmit a first control signal to an external device, wherein the first control signal comprises information on the manipulation of the local elongated medical member, and wherein the remote elongated medical member is configured to be manipulated based on the first control signal. This may allow for the remote elongated medical member to be manipulated remotely. UAB Inovatyvi medicina 30A-166 907

[0030] - 5 -

[0031] In some examples, the apparatus comprises a plurality of local elongated medical members and the apparatus is configured to manipulate a plurality of remote elongated medical members. This may allow for multiple elongated members to be manipulated simultaneously, thereby leading to a more accurate representation of a user manipulating a plurality of members during use of said members. In some examples, the local and / or remote elongated members may not be the same. The use of a catheter, a stent, a catheter balloon, a stent balloon, a thrombectomy device, a coil, a glue system, a guidewire or any other instrument that may be particularly useful in the field of endovascular systems. For example, the first member of the plurality of remote members may be a catheter, a second member of the plurality may be a stent and a third member may be a guidewire.

[0032] In some examples, the plurality of local elongated members is telescopically collapsible inside one another. This may allow for the apparatus to be more compact during use and / or storage and / or transportation of the apparatus as space for each of the plurality of members is not needed, but only for the longest of the plurality of local members. Additionally, this may allow for, for example, a guidewire and / or catheter to be placed inside another catheter. This, in turn, may allow for manipulation of the guidewire and / or catheter to be made easier as it is already within the other catheter, thereby improving ease of use of the system.

[0033] In some examples, the transmitter is configured to transmit a first control signal to the external device, wherein the first control signal comprises information on the manipulation of each of the plurality of local elongated members. This may allow for the signals to be transmitted independently from one another to different remote locations. This may allow for the plurality of remote elongated medical members to be manipulated independently from one another.

[0034] In some examples, each of the plurality of local elongated medical members corresponds to one of the plurality of remote elongated medical members, wherein the number of local elongated medical members and the number of remote elongated medical members are equal. This may allow for one local elongated member at the apparatus to be linked to a remote elongated medical member. This may allow for each remote elongated medical member to be manipulated independently from the other remote elongated medical members. UAB Inovatyvi medicina 30A-166 907

[0035] - 6 -

[0036] In some examples, the apparatus further comprises a plurality of gripping units, wherein each gripping unit is configured to grip a different one of the plurality of local elongated medical members. These gripping units may be the same, or the same design as, the gripping unit disclosed above.

[0037] In some examples, the apparatus further comprises a drive gear couplable to the gripping unit and / or the local elongated medical member, and wherein the manipulation of the local elongated medical member is configured to be aided by the drive gear. The local elongated member may be directly or indirectly coupled to the gear. This may allow for the local elongated member to be manipulated in ways that aid with the use of the external device that are not possible when the elongated member is being manipulated by a human hand. This, therefore, may allow for the external device and the apparatus to be used in a greater range of applications when compared to human manipulation. This may also allow for a more refined rotation of the local / remote elongated member, thereby mirroring the manipulation of the lo- cal / remote elongated member by a human. Any other suitable means for manipulating the local member such as, for example a linear drive, a linear actuator, or a motorized transmission may additionally or alternatively be used.

[0038] In some examples, the gripping unit is rotatable by a rotation unit, wherein the local elongated medical member is rotatable about its longitudinal axis as the local elongated medical member is gripped by the gripping unit and the gripping unit is rotated by the rotation unit. The rotation unit may be directly or indirectly coupled to the gripping unit via a set of gears coupled to a motor and / or a bearing and / or a shaft and / or any other suitable component that is configurable to rotate the gripping unit such as, for example, a timing pulley and belt coupled to a motor. This may ensure that the elongated member does not slip / fall out of the opening during the rotation of the elongated member.

[0039] In some examples, when a limit of the first and / or second parameter has been reached, the haptic feedback unit is configured to provide a haptic feedback signal to the user indicating that the limit has been reached. This may allow for the user to identify when a recentering process, as described herein, needs to be undertaken and / or when the member has reached its length and / or rotational limit. This may allow for an increase in patient safety and / or protection of the member, as the member is not pushed beyond its operational limits. UAB Inovatyvi medicina 30A-166 907

[0040] - 7 -

[0041] In some examples, the limit is a movement limit of the local elongated medical member and / or a limit of a force applied to the local elongated medical member. This may allow for the user to identify when a recentering process needs to be undertaken and / or when the member has reached its length and / or rotational limit and / or force limit. This may allow for an increase in patient safety and / or protection of the member, as the member is not pushed beyond its operational limits.

[0042] In some examples, the device is a foot pedal, and wherein upon the foot pedal being not depressed, the transmitter is configured to be disabled. This pedal may act as a "dead man's switch" and ensure that unintended movements of the remote elongated medical member are not transmitted to the external device via the first control signal. This, in turn, improves the safety of the apparatus.

[0043] In some examples, upon a movement of the device from a first position to a second position, the transmitter is configured to be disabled, and the local elongated medical member is configured to be moved, by the apparatus, to a predefined position. The elongated medical member may be moved to the predefined position via a linear encoder which is configured to track a linear position of the elongated medical member and a corresponding motor. For example, in the apparatus, a bigger diameter catheter may be coupled to a first module comprising the sensing unit and / or the gripping unit described herein. The linear encoder, and the apparatus, is configured to store the initial position of the first module, i.e. the predefined position, and the present position of the first module. If the device is moved from the first to the second position, the apparatus is configured to move the first module from the present position back to the initial position. If the initial and present positions are the same, the apparatus does not move the first module. This may create the effect that in the apparatus, the elongated medical member(s) is being manipulated by the user by being physically moved back and forward, meanwhile in the external device, there is a "retake mechanism" to ensure the remote elongated medical member(s) stays in place during the retake action. This may allow for the local elongated member to be moved without affecting the remote member. This may also allow for the local member to be shorter in length that the remote member, as the local member can be recentered several times, thereby making the apparatus more compact. This movement may be achieved via the drive gear described herein.

[0044] In some examples, upon a first toggling of a toggleable element of the apparatus, by the user, the transmitter is configured to be disabled and upon a second toggling, UAB Inovatyvi medicina 30A-166 907

[0045] - 8 - the transmitter is configured to be enabled. This may allow for the element to act as a "dead man's switch" and ensure that unintended movements of the local elongated medical member are not transmitted to the external device via the first control signal. The toggleable element may be a button, a lever, a switch, or any other suitable element that can be toggled by the user of the apparatus.

[0046] In some examples, upon the first toggling, the transmitter is configured to not transmit data relating to a subset of the plurality of local elongated medical members, and wherein upon the second toggling, the is configured to transmit data relating to the subset of the plurality of local elongated medical members. This may allow for the user to have more control over the manipulation of the remote members.

[0047] In some examples, upon a third toggling of the toggleable element of the apparatus, by the user, the remote elongated medical member is configured to be manipulated according to a first factor of a corresponding manipulation of the local elongated medical member, and upon a fourth toggling, the remote elongated medical member is configured to be manipulated according to a second factor of a corresponding manipulation of the local elongated medical member. This may allow for the user to have greater precision of the movement of the remote member. For example, upon the third toggling, the first factor may be 0.2. This may mean that for every 5 centimeters the local member is manipulated by the user, the remote member is manipulated by 1 centimeter. Upon the fourth toggling, the factor may be 1. The skilled person understands that any suitable factor may be used dependent on the scenario of the apparatus and / or external device. The above may be expressed as follows:

[0048] The local elongated medical member is moved by a distance X and / or rotated through a rotational angle Y, and the remote elongated medical member is moved by a distance Ci*X and / or rotated through a rotational angle Ci*Y when the first factor is applied, and is moved by a distance C2*X and / or rotated through a rotational angle C2*Y when the second factor is applied, wherein Ci ¥= C2, Ci > 0 and C2 > 0.

[0049] Although a first to fourth toggling is mentioned above, the skilled person understands that there may be a plurality of toggleable elements, and the first to fourth toggling may be shared between these elements. For examples, a first element may be assigned to the features described in the first and second toggling, and a second element may be assigned to the features described in the third and fourth toggling. UAB Inovatyvi medicina 30A-166 907

[0050] - 9 -

[0051] In some examples, the display device comprises a touchscreen. This may allow for the user to easily realize if the display device has been touched once or twice, and / or improve usability and accessibility of the apparatus. In some examples, the touchscreen comprises a visual indicator related to the operation of the apparatus such as, for example, an indication that the first control signal is not being transmitted. The touchscreen is preferably within easy reach of the user so that the user does not need to let go of the local elongated medical member in order to touch the touchscreen.

[0052] In the below, it is disclosed that various features can be achieved via a contact of the touchscreen. In the above, it is disclosed that various features can be achieved via toggling a toggleable element. The skilled person understands that these are not exclusive, and can be mixed and matched according to the apparatus and / or the user's needs and wishes. Indeed, in some examples, there may be both a toggleable element and a touchscreen configured to allow the same feature to be undertaken.

[0053] In some examples, upon a first contact, by the user, in a first region of the touchscreen, the transmitter is configured to be disabled and upon a second contact, the transmitter is configured to be enabled. This may allow for the touchscreen to act as a "dead man's switch" and ensure that unintended movements of the local elongated medical member are not transmitted to the external device via the first control signal.

[0054] In some examples, upon a third contact of the touchscreen, the remote elongated medical member is configured to be manipulated according to a first factor of a corresponding manipulation of the local elongated medical member, and wherein upon a fourth contact of the touchscreen, the remote elongated medical member is configured to be manipulated according to a second factor of a corresponding manipulation of the local elongated medical member. This may allow for the user to have greater precision of the movement of the remote member. For example, upon the third contact, the first factor may be 0.2. This may mean that for every 5 centimeters the local member is manipulated by the user, the remote member is manipulated by 1 centimeter. Upon the fourth contact, the factor may be 1. The skilled person understands that any suitable factor may be used dependent on the scenario of the apparatus and / or external device. The above may be expressed as follows: UAB Inovatyvi medicina 30A-166 907

[0055] - 10 -

[0056] The local elongated medical member is moved by a distance X and / or rotated through a rotational angle Y, and the remote elongated medical member is moved by a distance Ci*X and / or rotated through a rotational angle Ci*Y when the first factor is applied, and is moved by a distance C2*X and / or rotated through a rotational angle C2*Y when the second factor is applied, wherein Ci ¥= C2, Ci > 0 and C2 > 0.

[0057] In some examples, the user display is configured to display a distance between a present position of the local elongated medical member and a limit of its linear movement and / or a distance between a present position of the remote elongated medical member and a limit of its linear movement. This may allow the user of the apparatus to have a better idea of how they have manipulated the local member.

[0058] In some examples, when the distance between the present position of the local elongated medical member and / or the remote elongated medical member is below a predetermined threshold, the display device is configured to display an option to select an increased haptic feedback mode. This increased haptic feedback mode may allow for the user to more finely manipulate the local member and so, the remote member.

[0059] In some examples, upon a fifth contact of the touchscreen, the apparatus is configured to enter the increased haptic feedback mode where the haptic feedback provided by the haptic feedback unit is increased when compared to the apparatus not being in the increased haptic feedback mode. This increased haptic feedback mode may allow for the user to more finely manipulate the local member and so, the remote member. In some examples, it may not be a fifth contact, but a fifth toggling of the toggleable element.

[0060] In some examples, upon the first contact, the transmitter is configured to not transmit data relating to a subset of the plurality of local elongated medical members, and wherein upon the second contact, the transmitter is configured to transmit data relating to the subset of the plurality of local elongated medical members. This may allow for the user to have more control over the manipulation of the remote members.

[0061] In some examples, the apparatus further comprises a rail configured to couple medical equipment to the rail and / or apparatus. The rail is preferably a DIN rail, although the skilled person understands any suitable rail may be used. In some examples, UAB Inovatyvi medicina 30A-166 907

[0062] - 11 - there may be a plurality of rails. The use of such a rail may allow for standard medical equipment to be coupled to the rail and / or apparatus using, for example, a clamp. The term "standard medical equipment" may relate to, for example, an IV line / bag, a pulsometer, a heart monitor, or any other well known and commonly used medical equipment. The rail may be foldable and / or stowable, thereby making the apparatus more compact when not in use.

[0063] In some examples, the apparatus further comprises a plurality of lifting legs configured to adjust a height of the apparatus. This may allow for the apparatus to be more versatile, as the apparatus can be adjusted for different heights of users, as well as being adjusted between "standing up" and "sitting down" positions. The lifting legs may be manually operated, or electrically operated via the use of, for example, an actuator which may help adjust the height of the apparatus.

[0064] In some examples, the apparatus further comprises a visual indicator configured to indicate that the first control signal is not being transmitted. This may allow for the user to easily see that the movements of the local elongated medical member are not being transmitted, and so, the user is free to move the local elongated medical member. In some examples, if the local elongated medical member is moved and the first control signals are not being transmitted, an audio indicator may additionally, or alternatively, be used.

[0065] In some examples, upon a first additional touch of the touchscreen, information on only an axial or rotational manipulation of the local elongated medical member is transmitted and upon a second additional touch, information on only an axial or rotational manipulation of the local elongated medical member is not transmitted. This may be particularly helpful if the user wants to manipulate the remote elongated medical member, via the first control signal, in only the first and second directions or wants to only rotate the remote elongated medical member. This may further improve safety of the apparatus as unintended movements are not transmitted to the external device, via the first control signal. The additional touches may be the same, or different, to the touches mentioned above.

[0066] According to a second aspect, we describe a system for manipulating a remote elongated medical member comprising: the apparatus according to the first aspect; and an external device comprising or being coupled to the remote elongated medical UAB Inovatyvi medicina 30A-166 907

[0067] - 12 - member, and further comprising or being coupled to a transceiver configured to receive the first control signal.

[0068] In some examples, the transmitter is configured to transmit a first control signal to the transceiver of the external device, wherein the first control signal comprises information on the manipulation of the local elongated medical member, wherein the apparatus is located in a first location and the external device is located at a second location, wherein the first and second locations are different locations. The information may relate to the distance the local elongated medical member has been moved in a predetermined direction, a rotation of the local elongated medical member, a force that has been applied on the local elongated medical member or any other suitable information. This may allow for the external device to receive important information about the manipulation of the local elongated medical member.

[0069] In some examples, the transceiver of the external device is configured to receive the first control signal and the external device is configured to manipulate the remote elongated medical member based on the received first control signal. This may allow for the remote manipulation of the remote elongated medical member via the manipulation, by a human, of the local elongated medical member.

[0070] In some examples, the remote elongated medical member is configured to be manipulated according to a third factor of a corresponding manipulation of the local elongated medical member. This may allow for the remote manipulation of the remote elongated medical member via the manipulation, by a human, of the local elongated medical member. The third factor may be the same as the first and / or second factor mentioned above, or may be any other suitable factor.

[0071] In some examples, the control unit further comprises a receiver, wherein the control unit is configured to receive, via the receiver, a second control signal from the transceiver of the external device, wherein the control signal comprises information on the remote elongated medical member. This may allow the user at the apparatus to feel what is happening at the external device / remote member, and realize if the movement of the remote elongated medical member has been blocked, for example, as the haptic feedback may be suddenly greatly increased. This may also allow for the apparatus to receive information on the status of the remote elongated medical member. In some examples, this status may be shown on the user display. This may therefore improve the safety of the apparatus as the user can see, on the user dis- UAB Inovatyvi medicina 30A-166 907

[0072] - 13 - play, if the remote elongated medical member is malfunctioning and / or if the external device is not receiving the first control signal properly. The receiver may be part of the control unit, or may alternatively be located in a separate part of the apparatus.

[0073] In some examples, the haptic feedback provided to the user, by the haptic feedback unit of the apparatus, is based on the received second control signal. This may allow for the user of the apparatus to feel what is happening at the external device and realize if the movement of the remote elongated medical member has been blocked, for example, as the haptic feedback may be suddenly greatly increased.

[0074] In some examples, the gripping unit of the apparatus is moveable and / or rotatable based on the received second control signal. The local elongated member is preferably fixed with respect to the gripping unit, and the gripping unit is coupled to a sensing unitand / or a linear drive and / or a rotational drive to allow for the movement and rotation of the gripping unit.

[0075] In some examples, there is an external device for each one of the plurality of local elongated medical members. This may allow for the remote manipulation of a plurality of different remote elongated medical members at a plurality of different remote locations.

[0076] In some examples, the transceiver of the external device is configured to receive the first control signal and the external device is configured to manipulate the plurality of remote elongated medical members based on the received first control signal. This may allow for the remote manipulation of the plurality of remote elongated medical members via the manipulation, by a user, of the plurality of elongated members at the apparatus.

[0077] In some examples, the apparatus further comprises a plurality of haptic feedback units configured to provide haptic feedback to the user of the apparatus based on the received second control signal, wherein each of the plurality of haptic feedback units is couplable to a different one of the plurality of local elongated medical members. This may allow user at the apparatus to feel what is happening at the external device(s) and realize if the movement of at least one of the plurality of remote elongated medical members has been blocked, for example, as the haptic feedback may be suddenly greatly increased. UAB Inovatyvi medicina 30A-166 907

[0078] - 14 -

[0079] In some examples, at least one of the plurality gripping units of the apparatus is moveable and / or rotatable based on the received second control signal. The local elongated member is preferably fixed with respect to the gripping unit, and the gripping unit is coupled to a sensing unit and / or a linear drive and / or a rotational drive to allow for the movement and rotation of the gripping unit.

[0080] In some examples, the second parameter comprises a distance the remote elongated member has been manipulated and / or a rotational angle through which the remote elongated member has been manipulated, from a predetermined position and / or a force exerted on the remote elongated medical member. This may allow for the user to have a better idea of how they have manipulated the remote member, and how this translates to the local member. It may also allow for the user to receive more information on the remote member, and therefore improve patient safety. This may also allow the user to know if the remote elongated medical member is reaching a limit of movement / force, thereby extending the lifetime of the remote member, and also protecting it from damage.

[0081] In some examples, when the limit of the second parameter has been reached, the haptic feedback unit of the apparatus is configured to provide a haptic feedback signal to the user indicating that the limit has been reached, wherein the limit is a movement limit of the remote elongated medical member and / or a force applied to the remote elongated medical member. This may allow for the user to identify when a recentering process, as described herein, needs to be undertaken and / or when the member has reached its length and / or rotational limit. This may allow for an increase in patient safety and / or protection of the member, as the member is not pushed beyond its operational limits.

[0082] According to a third aspect, we describe an apparatus for manipulating a local elongated medical member and a remote elongated medical member, the apparatus comprising: a control unit comprising a transmitter; a sensing unit configured to sense a first parameter of the manipulated local elongated medical member; and a haptic feedback unit configured to provide haptic feedback to the user of the apparatus based on the first parameter. UAB Inovatyvi medicina 30A-166 907

[0083] - 15 -

[0084] The apparatus may be of any suitable design and / or shape as long as it comprises the above-mentioned features. This may allow for the apparatus to be modified to the situation and / or environment said apparatus is in.

[0085] In some examples, the local and / or remote elongated members may be a catheter, a stent, a catheter balloon, a stent balloon, a thrombectomy device, a coil, a glue system, a guidewire or any other instrument that may be particularly useful in the field of endovascular systems. In some examples, the local and / or remote elongated members may not be the same. That is to say, the remote member may be, for example, a catheter and the local member may be, for example, a stent.

[0086] The control unit may be located at a location remote from the remote elongated medical member and be coupled to the apparatus and / or control unit via wired and / or wireless means. The local elongated medical member is preferably configured to be manipulated by a human, and is preferably located at the same location as to control unit, the sensing unit and the haptic feedback unit. In some examples, the local elongated medical member is a replica of the remote elongated medical member, or is a representation of the remote elongated medical member. This may allow for the human to have a better understanding of the feel of the remote elongated medical member as the local elongated medical member comprises, preferably, the same materials and dimensions as the remote elongated medical member.

[0087] The sensing unit is preferably configured to sense a movement of the manipulated local elongated medical member. The sensing unit may comprise mechanical and / or magnetic and / or optical means in order to sense this movement. This movement may be sensed in the longitudinal axis of the elongated medical member and / or the rotational axis of the elongated medical member. Each local elongated medical member is preferably coupled to a sensing unit. Each sensing unit is preferably coupled to a gripping unit of the apparatus, as is described in more detail below.

[0088] The haptic feedback unit may allow for the user of the apparatus to feel what is happening at the remote member and realize if the movement of the remote elongated medical member has been blocked, for example, as the haptic feedback may be suddenly greatly increased. UAB Inovatyvi medicina 30A-166 907

[0089] - 16 -

[0090] Any advantages and features described in relation to any of the above aspects and examples may be realized in any one or more of the other aspects and examples described above.

[0091] It is clear to a person skilled in the art that certain features of the system set forth herein may be implemented under use of hardware (circuits), software means, or a combination thereof. The software means can be related to programmed microprocessors or a general computer, an ASIC (Application Specific Integrated Circuit) and / or DSPs (Digital Signal Processors). For example, a processing unit may be implemented at least partially as a computer, a logical circuit, an FPGA (Field Programmable Gate Array), a processor (for example, a microprocessor, microcontroller (pC) or an array processor) / a core / a CPU (Central Processing Unit), an FPU (Floating Point Unit), NPU (Numeric Processing Unit), an ALU (Arithmetic Logical Unit), a Coprocessor (further microprocessor for supporting a main processor (CPU)), a GPGPU (General Purpose Computation on Graphics Processing Unit), a multi-core processor (for parallel computing, such as simultaneously performing arithmetic operations on multiple main processor(s) and / or graphical processor(s)) or a DSP.

[0092] The above aspect may also apply to a method (in particular of manipulating an elongated member and / or a remote elongated medical member).

[0093] Additionally, although an endovascular robotic system is described herein, the skilled person understands that the apparatus may be used in a vascular robotic system, or any other suitable medical robotic system.

[0094] BRIEF DESCRIPTION OF THE DRAWINGS

[0095] These and other aspects of the invention will now be further described, by way of example only, with reference to the accompanying figures, wherein like reference numerals refer to like parts, and in which:

[0096] Figure 1 shows a block diagram of an apparatus according to some example implementations as described herein;

[0097] Figure 2 shows a schematic view of an apparatus according to some example implementations as described herein; UAB Inovatyvi medicina 30A-166 907

[0098] - 17 -

[0099] Figure 3 shows a schematic view of an apparatus according to some example implementations as described herein;

[0100] Figure 4 shows a schematic view of an apparatus according to some example implementations as described herein;

[0101] Figure 5 shows a schematic view of an apparatus according to some example implementations as described herein;

[0102] Figure 6 shows a top-down view of an apparatus according to some example implementations as described herein;

[0103] Figure 7 shows a schematic view of a display unit according to some example implementations as described herein; and

[0104] Figure 8 shows a block diagram of a system according to some example implementations as described herein.

[0105] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0106] In the present disclosure, we describe a remote workstation dedicated for control and manipulation of endovascular devices loaded on a bedside unit, i.e. a patient module, which is in a different location. The remote workstation and the bedside unit may be coupled by a data link, which may be wired and / or wireless. The remote workstation may enable control and manipulation via a haptic interface implemented as coupled endovascular devices, wherein the local and remote devices are coupled. The workstation may act as a user interface implemented as physically coupled endovascular devices, but is intended to control the endovascular devices loaded at the remote location.

[0107] Figure 1 shows a block diagram of an apparatus according to some example implementations as described herein.

[0108] The apparatus 100 comprises a control unit 101 comprising a transmitter 101a and a receiver 101b. The control unit 101 may use any suitable communication protocol, wherein the transmitter 101a is configured to transmit a control signal to the external device (see figure 8) and the receiver 101b is configured to receive a control signal UAB Inovatyvi medicina 30A-166 907

[0109] - 18 - form the external device. In some examples, the control unit 101 may act as a (microcontroller. In some examples, the transmitter 101a and receiver 101b are located in different parts of the apparatus 100. In some examples, the receiver 101b is configured to receive data relating to linear and / or rotational motion and / or force and / or position data of the remote elongated medical member (see figure 8), which may also be an endovascular device / medical member. In some examples, the transmitter 101a is configured to transmit data relating to linear and / or rotational motion and / or force and / or position data of the local medical member.

[0110] The local elongated medical member 1001 may be, for example, a catheter, a stent, a catheter balloon, a stent balloon, a thrombectomy device, a coil, a glue system, a guidewire or any other instrument that may be particularly useful in the field of endovascular systems.

[0111] The gripping unit 1002 may be any suitable unit configured to grip the local elongated medical member 1001 in place during operation of the apparatus. The gripping unit 1002 preferably comprises means for gripping the local elongated member 1001. This gripping may be permanent, via, for example, gluing, or may be temporary, allowing for the gripping unit 1002 to repeatedly grip and ungrip the local elongated medical member 1001 depending on the needs of the apparatus 100.

[0112] The sensing unit 1003 is configured to sense a movement of the local elongated medical member 1001. The sensing unit 1003 may comprise mechanical and / or magnetic and / or optical means in order to sense this movement. This movement may be sensed in the longitudinal axis of the elongated medical member 1001 and / or the rotational axis of the elongated medical member 1001. Each local elongated medical member 1001 is preferably coupled to a respective sensing unit.

[0113] The device 104, shown herein as a foot pedal, is described in more detail below. Although a foot pedal is shown, the skilled person understands that the device 104 may be a lever, a button, a switch, or any other suitable component configured to carry out the functions of the device 104.

[0114] The haptic feedback unit 105 and the user display 106 are described in more detail below. UAB Inovatyvi medicina 30A-166 907

[0115] - 19 -

[0116] The drive gear 1004 may comprise a linear and / or rotational drive gear, with force and / or position sensing capabilities and is coupled to the local elongated medical member 1001. This may allow for a close to real feeling of the member(s) located in the remote location. The drive gear may be any suitable component configured to aid manipulation of the local elongated medical member 1001.

[0117] Figures 2 and 3 show schematic views of an apparatus according to some example implementations as described herein.

[0118] In these examples, the apparatus 100 is shown in two parts. The apparatus may serve as the control center where the operating Physician sits and manipulates the local elongated medical member(s) 1001.

[0119] The apparatus 100 comprises:

[0120] • the control side, coupled to the external device, comprising the control unit 101, part of the elongated medical member 1001, the gripping unit 1002, the sensing unit 1003 and the drive gear 1004;

[0121] • the device 104, herein referred to as an Activation Pedal; and

[0122] • the cockpit comprising part of the elongated medical member 1001, the haptic feedback unit 105 and the user display 106.

[0123] The control side is, in this example, equipped with specialized robotic modules which may comprise the gripping unit 1002 and / or the sensing unit 1003. The modules equipped with the gripping unit 1002 and / or the sensing unit 1003 may, in some examples, comprise permanently attached elongated medical members 1001. These elongated medical members 1001 are used as a haptic interface 105, enabling the user to control single-use remote elongated medical members in the remote location through linear and rotational movements. The control side and the external device may replicate each other's movements, ensuring motion mimicking, except for retake and recentering, as described herein. This system interface also allows the operating physician to perceive the resistance encountered by the remote elongated medical members that may be located inside the patient's vessels.

[0124] The haptic interface 105 allows the physician to execute linear movements of up to, preferably + / - 125 mm, although other distances will be understood to be possible by the skilled person, and unlimited rotational movements with a single press of the UAB Inovatyvi medicina 30A-166 907

[0125] - 20 -

[0126] Activation Pedal. Upon releasing the pedal, the interface devices are recentered to their original position, while keeping the remote medical members still at the remote location. The "original position" is also defined as the "initial position" and the "predefined position" herein. That is to say, in some examples, the elongated medical member 1001 may be moved to the predefined position via a linear encoder (not shown) which is configured to track a linear position of the elongated medical member and a corresponding motor / drive gear 1004. For example, in the apparatus 100, a bigger diameter catheter may be coupled to a first module comprising the sensing unit 1003 and / or the gripping unit 1002 described herein. The linear encoder, and the apparatus 100, is configured to store the initial position of the first module, i.e. the predefined position, and the present position of the first module. If the device 104 is moved from the first to the second position, the apparatus 100 is configured to move the first module from the present position back to the initial position. If the initial and present positions are the same, the apparatus 100 does not move the first module. This may create the effect that in the apparatus 100, the elongated medical member(s) 1001 is being manipulated by the user by being physically moved back and forward, meanwhile in the external device 2000, there is a "retake mechanism" to ensure the remote elongated medical member(s) 2001 stays in place during the retake action.

[0127] After a retake action, the physician can resume the procedure by pressing the Activation Pedal and continue manipulating the local elongated medical member 1001. Additionally or alternatively, the Activation Pedal may act as a dead man's switch, wherein the transmitter 101a is only active and transmitting while the Activation Pedal is depressed by the user.

[0128] The apparatus 100 should, preferably, be placed in a remote, X-ray well protected environment at a distance from the Bedside Unit / external device. The apparatus 100 and the Bedside Unit may be connected via a communication cable, which is hardwired through the apparatus 100.

[0129] The cockpit houses at least one additional touchscreen 106, 107 with a graphic user interface (GUI) for controlling the apparatus 100. The at least one touchscreen 106 may comprise: a procedure touchscreen; and an endovascular device touchscreen. UAB Inovatyvi medicina 30A-166 907

[0130] - 21 -

[0131] These touchscreens 106, 107 may be located on, or mounted on, a surface of the apparatus 100 and cockpit. Although a plurality of touchscreens 106, 107 are shown here, the skilled person understands that these capabilities may be merged into a single touchscreen 106. The touchscreen 106 shows at least one medical member loaded into the remote location, and may allow for a request to change or unload said medical member.

[0132] The Cockpit further includes additional mounting fixtures for additional equipment, such as, for example, a camera display 111 which may be tabletop mounted, and an X-ray display 112, which may be VESA mounted. These may be mounted via the brackets 113, 114 shown in Figure 3. The skilled person understands that any suitable additional equipment may be connected, coupled or mounted to the surface 102 or the apparatus 100 depending on the scenario the apparatus 100 is being used for.

[0133] The haptic feedback unit 105 may be located on a surface 102 of the apparatus 100. The haptic feedback unit 105 may provide vibration and / or sound feedback upon programmed situations, so that the user can feel the system response in situations, such as:

[0134] - There being no length of the devices left to manipulate at the remote location; and / or

[0135] - There being no length of the medical member(s) 1001 left to manipulate at the apparatus 100; and / or

[0136] - The medical members at the remote location devices are stuck / excessive force is needed to manipulate these devices from the apparatus.

[0137] In some examples, secondary haptic feedback is provided by the UI via the haptic feedback unit 105. The coupled medical members at the local and remote locations may rotate or move linearly upon programmed situations, so that the user can feel the system response in situations, such as a takeover action of the remote member being not completed.

[0138] The skilled person understands that other scenarios may be used, and that the haptic and / or sound feedback may be altered depending on the user's wishes. UAB Inovatyvi medicina 30A-166 907

[0139] - 22 -

[0140] Although one elongated medical member 1001 is shown and described herein, the skilled person understands that the same principle applies to a plurality of elongated medical members 1001.

[0141] The apparatus may further comprise adjustable position surgical table rails 108, 109 (DIN rails) are fixed on the apparatus 100, so the standard medical equipment on the rails 108, 109 / apparatus 100 can be placed using standard clamps. This may allow for the apparatus 100 to be more versatile. These rails 108, 109 may be foldable and / or stowable, thereby making the apparatus 100 more compact when they are not in use.

[0142] Figures 4 and 5 show schematic views of an apparatus according to some example implementations as described herein.

[0143] In the examples of figures 2 and 3, the control side and the cockpit are located side by side, but the control side can be placed / slid over the cockpit, as seen in figures 4 and 5. This may allow for space to be saved, and for a more compact apparatus 100. This is particularly preferable when the apparatus 100 needs to be moved to a separate location, or moved into storage.

[0144] In some examples, the apparatus 100 is mounted on a plurality of wheels 103. This may allow for the apparatus 100 to be mobile, and be easily moved between locations in, for example, a medical facility.

[0145] In some examples, the apparatus 100 has lifting legs 103 for sitting and standing positions, thereby allowing for height adjustment. This may improve the versatility of the apparatus 100

[0146] Figure 6 shows a top-down view of an apparatus according to some example implementations as described herein.

[0147] The reference numerals in figure 6 correspond to those seen in figures 2 to 5.

[0148] Figure 7 shows a schematic view of a display unit according to some example implementations as described herein. UAB Inovatyvi medicina 30A-166 907

[0149] - 23 -

[0150] Throughout the following, although the display unit is described in terms of three elongated medical members, the skilled person understands that there may be a single member, or any suitable number of members capable of being controlled and / or manipulated via the display unit.

[0151] The control Ul / touchscreen 106 showing a parameter / parameters of the local elongated medical member 1001 and / or the remote elongated medical member may be integrated in a table surface, as seen in figures 2, 3 and 6

[0152] Visualization 124 of the loaded remote member lengths in relation one to other, in relation to patient access area, or in relation to any other suitable position may be shown on the touchscreen 106, and is shown in the upper part of figure 7.

[0153] A member lock button allowing to lock / unlock the motion of the particular remote medical member may also be shown on the touchscreen 106. For example, upon a first contact, by the user, in a first region of the touchscreen 106, the transmitter is configured to be disabled, i.e. locked, and upon a second contact, the transmitter is configured to be enabled, i.e. unlocked. As a further example, as can be seen in figure 7, only one of the remote members may be locked via a contact with its respective part 121, 122, 123 of the touchscreen 106. Resultantly, the chosen member may be fixed in place at the remote location while the user manipulates the first and third remote members. The locking portions of the touchscreen 106 can be of a fixed length, as seen in figure 7, or can be an adjustable width, so the widths of the locking portions of the touchscreen 106 follow the positioning of the remote members, or can be fixed in a chosen position on the touchscreen 106. In each scenario, the locking portions are in position near the user's fingers manipulating the local members 1001. In some examples, a status of each remote member is displayed above the its respective block 121, 122, 123, and can be either "Locked" or "Unlocked".

[0154] In some examples, the touchscreen 106 comprises a precise mode activa- tion / deactivation button. This mode allows for motion scaling meaning that, for example, a 5 mm motion of the local elongated medical members 1001 equals a 1 mm motion of the corresponding remote elongated medical member. This may be equivalent to the factors mentioned herein. The skilled person understands that any suitable motion scaling may be used. Upon deactivation of the precise mode, the scaling may return to 1:1. To exit the Precision Mode and return to normal operation, the user may need to release the Activation Pedal 104, slide a Precision Mode GUI but- UAB Inovatyvi medicina 30A-166 907

[0155] - 24 - ton / toggle on the touchscreen 106, and select "Exit Precision Mode". The skilled person understands that there may be other ways of entering / exiting the Precision Mode, which can be customized based on the needs and wishes of the user. The touchscreen 106 may display indication an additional color while the apparatus 100 is operating in the Precision Mode.

[0156] The touchscreen 106 may display one or more of:

[0157] - System information such as, for example, current state of at least one elongated medical member and apparatus settings;

[0158] - Procedure information such as, for example, patient ID, procedure type, date, time; and

[0159] - Endovascular devices (elongated medical members) loaded at the remote loca- tion / external device.

[0160] The touchscreen 106 may enable the user to:

[0161] - Request a change or an unload of the elongated medical members at the remote location; and / or

[0162] - Turn the Precision Mode on or off.

[0163] Information relating to the remote elongated medical members is displayed, in this example, in dedicated areas 121, 122, 123 of the touchscreen 106. Each remote member may be represented in a different color according to the user's wishes and / or may comprise a different pattern, such as, for example, checkerboard, crosses, lines and so on. For example:

[0164] - Yellow 121 may represent a catheter-based device with the largest diameter of the loaded remote members, any may typically be a guiding catheter;

[0165] - Blue 122 may represent a middle catheter-based device, such as, for example, a diagnostic catheter, a PTA balloon catheter, a stent, or a microcatheter; and

[0166] - Green 123 may represent a guidewire.

[0167] The skilled person understands that the colors and instruments may be customized by the user of the apparatus 100. UAB Inovatyvi medicina 30A-166 907

[0168] - 25 -

[0169] A secondary touchscreen / screen 107 may be integrated into a central section of the Cockpit's tabletop. This touchscreen / screen 107 may display:

[0170] - Names and parameters of endovascular devices, loaded into the external device (to some extent duplicating information from the touchscreen 106 mentioned above); and / or

[0171] - Basic information on the position of remote members in relation to an introducer and / or each other.

[0172] The touchscreen / screen 107 may additionally or alternatively allow the user to lock or unlock the position of each remote member, similar to the touchscreen 106 mentioned above. Each remote member may be displayed with a color block similar to those 121, 122, 123 mentioned above. In the present disclosure, when the touchscreen 106 is mentioned, the same features may apply to the touchscreen / screen 107. In some examples, the touchscreen 106 and the touchscreen / screen 107 may share displaying the features mentioned herein and / or may duplicate the display of at least one feature mentioned herein.

[0173] When a remote member has reached its linear movement end position, a 0 may be displayed above the respective device in the touchscreen 106, as seen in the upper part 124 of figure 7.

[0174] When the apparatus 100 indicates that the device length limit has been reached, and the displayed value shown above the respective member on the touchscreen 106 is below a predetermined threshold, the apparatus 100 and / or touchscreen 106 may provide an option to enter the device hub zone, where wire and / or inflation ports are located. This function is called Extra Distance and may be displayed next to the remaining distance in the upper part 124 of the touchscreen 106. This may enable the user to manipulate the local endovascular member 1001 associated with the remote member, with significantly increased haptic force feedback, until the remote member reaches its absolute limit. Additionally or alternatively, this mode may also be displayed, and chosen, when the local member 1001 is nearing a limit of its length limit.

[0175] The upper part 124 of the touchscreen 106, in this example, displays a position of remote member and / or local member 1001 and its relation to the other members in the local location / remote location. The remaining usable length, measured in centimeters, is indicated by numbers marked in the color representing the device, i.e. UAB Inovatyvi medicina 30A-166 907

[0176] - 26 - yellow, blue or green. Other units may alternatively be used according to the wishes of the user.

[0177] The numbers displayed on the touchscreen 106 may indicate the length of the device inserted into a body, measured in centimeters, or any other suitable unit. If a negative value is displayed, it may indicate the remaining length necessary for the second remote member to protrude through the first remote member.

[0178] When the user requests a member change at the remote location, the touchscreen 106 may be disabled by the apparatus 100. The touchscreen 106 may become active once a medical professional at the remote location confirms that the loading of the new member has been completed and that there are no other unintended medical personnel near the X-ray source, or any other equipment that may cause damage to the professional.

[0179] Although a layout of the touchscreen 106, 107 has been described above, the skilled person understands that the features shown on the touchscreen 106, 107 may be placed in any suitable position according to the needs and wishes of the user of the apparatus 100.

[0180] Figure 8 shows a block diagram of a system according to some example implementations as described herein.

[0181] As can be seen, the system 3000 comprises the apparatus 100 and the remote device 2000, which is also described herein as a Bedside Unit, or a device at a remote location. The remote device 2000 comprises the remote elongated medical member 2001, which may be referred to herein as an (remote) endovascular device, as well as a transceiver 2002. The transceiver 2002 may communicate with the apparatus 100 by receiving the first control signals mentioned herein and by transmitting the second control signals mentioned herein.

[0182] It is to be understood that terms such as "controls", "transmits", "receives", "manipulates" and the like within the present writ should also be understood be mean that the feature is configured to be controlled and / or manipulated and that a signal is configured to be transmitted and / or received and so on. UAB Inovatyvi medicina 30A-166 907

[0183] - 27 -

[0184] No doubt many other effective alternatives will occur to the skilled person. It will be understood that the invention is not limited to the described embodiments and encompasses modifications apparent to those skilled in the art and lying within the scope of the claims appended hereto.

Claims

UAB Inovatyvi medicina 30A-166 907- 28 -CLAIMS1. An apparatus (100) for manipulating a remote elongated medical member, the apparatus (100) comprising: a control unit (101) comprising a transmitter (101a); a local elongated medical member (1001) configured to be manipulated by a user of the apparatus (100); a sensing unit (1003) configured to sense a first parameter of the local elongated medical member (1001); and a haptic feedback unit (105) configured to provide haptic feedback to the user of the apparatus (100) based on the first parameter.

2. The apparatus (100) of claim 1, further comprising a device configured to enable and disable the transmitter (101a).

3. The apparatus (100) of claim 1 or 2, further comprising a user display (106) configured to display the first parameter of the local elongated medical member (1001) and / or a second parameter of the remote elongated medical member.

4. The apparatus (100) of any one of the preceding claims, wherein the local elongated medical member (1001) is configured to be manipulated in two axes of movement, in particular wherein the axes are a longitudinal axis of the local elongated medical member (1001) and a rotational axis around the longitudinal axis of the local elongated medical member (1001).

5. The apparatus (100) of any one of the preceding claims, wherein the first parameter comprises a distance the local elongated medical member (1001) has been manipulated and / or a rotational angle through which the local elongated medical member (1001) has been manipulated, from a predetermined position.

6. The apparatus (100) of any one of the preceding claims, when dependent on claim 3, wherein the first parameter comprises a force exerted on the local elongated medical member (1001)7. The apparatus (100) of any one of the preceding claims, further comprising a gripping unit (1002) configured to grip the local elongated medical member (1001),UAB Inovatyvi medicina 30A-166 907- 29 - wherein the gripping unit (1002) is moveable and / or rotatable based on the manipulation of the local elongated medical member (1001).

8. The apparatus (100) of any one of the preceding claims, wherein the transmitter (101a) is configured to transmit a first control signal to an external device, wherein the first control signal comprises information on the manipulation of the local elongated medical member (1001), and wherein the remote elongated medical member is configured to be manipulated based on the first control signal.

9. The apparatus (100) of any one of the preceding claims, wherein the apparatus (100) comprises a plurality of local elongated medical members (1001) and the apparatus (100) is configured to manipulate a plurality of remote elongated medical members.

10. The apparatus (100) of claim 9, wherein the plurality of local elongated medical members (1001) are telescopically collapsible inside one another.

11. The apparatus (100) of any one of claim 9 or 10, wherein each of the plurality of local elongated medical members (1001) corresponds to one of the plurality of remote elongated medical members, wherein the number of local elongated medical members (1001) and the number of remote elongated medical members are equal.

12. The apparatus (100) of any one of claims 9 to 11, further comprising a plurality of gripping units (1002), wherein each gripping unit (1002) is configured to grip a different one of the plurality of local elongated medical members (1001).

13. The apparatus (100) of claim 12, wherein at least one of the plurality of gripping units (1002) is moveable and / or rotatable based on the manipulation of its respective local elongated medical member (1001).

14. The apparatus (100) of any one of the preceding claims, wherein the apparatus (100) further comprises a drive gear (1004) couplable to the gripping unit (1002) and / or the local elongated medical member (1001), and wherein the manipulation of the local elongated medical member (1001) is configured to be aided by the drive gear (1004).

15. The apparatus (100) of any one of the preceding claims, when dependent on claim 3, wherein, when a limit of the first and / or second parameter has beenUAB Inovatyvi medicina 30A-166 907- 30 - reached, the haptic feedback unit (105) is configured to provide a haptic feedback signal to the user indicating that the limit has been reached.

16. The apparatus (100) of claim 15, wherein the limit is a movement limit of the local elongated medical member (1001) and / or a force applied to the local elongated medical member (1001).

17. The apparatus (100) of any one of the preceding claims, when dependent on claim 2, wherein the device (104) is a foot pedal, and wherein upon the foot pedal being not depressed, the transmitter (101a) is configured to be disabled.

18. The apparatus (100) of any one of the preceding claims, when dependent on claim 2, wherein upon a movement of the device (104) from a first position to a second position, the transmitter (101a) is configured to be disabled, and the local elongated medical member (1001) is configured to be moved, by the apparatus (100), to a predefined position.

19. The apparatus (100) of any one of the preceding claims, wherein upon a first toggling of a toggleable element of the apparatus (100), by the user, the transmitter (101a) is configured to be disabled and upon a second toggling, the transmitter (101a) is configured to be enabled.

20. The apparatus (100) of claim 19, when dependent on claim 9, wherein upon the first toggling, the transmitter (101a) is configured to not transmit data relating to a subset of the plurality of local elongated medical members (1001), and wherein upon the second toggling, the transmitter (101a) is configured to transmit data relating to the subset of the plurality of local elongated medical members (1001).

21. The apparatus (100) of any one of the preceding claims, wherein upon a third toggling of the toggleable element of the apparatus (100), by the user, the remote elongated medical member is configured to be manipulated according to a first factor of a corresponding manipulation of the local elongated medical member (1001), and upon a fourth toggling, the remote elongated medical member is configured to be manipulated according to a second factor of a corresponding manipulation of the local elongated medical member (1001).UAB Inovatyvi medicina 30A-166 907- 31 -22. The apparatus (100) of any one of the preceding claims, when dependent on claim 3, wherein the user display (106) comprises a touchscreen.

23. The apparatus (100) of claim 21, wherein upon a first contact, by the user, in a first region of the touchscreen, the transmitter (101a) is configured to be disabled and upon a second contact, the transmitter (101a) is configured to be enabled.

24. The apparatus (100) of claim 22 or 23, wherein, upon a third contact of the touchscreen, the remote elongated medical member is configured to be manipulated according to a first factor of a corresponding manipulation of the local elongated medical member (1001), and wherein upon a fourth contact of the touchscreen, the remote elongated medical member is configured to be manipulated according to a second factor of a corresponding manipulation of the local elongated medical member (1001).

25. The apparatus (100) of any one of the preceding claims, when dependent on claim 3, wherein the user display (104) is configured to display a distance between a present position of the local elongated medical member (1001) and a limit of its linear movement and / or a distance between a present position of the remote elongated medical member and a limit of its linear movement.

26. The apparatus (100) of claim 25, wherein, when the distance between the present position of the local elongated medical member (1001) and / or the remote elongated medical member and their respective limits is below a predetermined threshold, the user display (106) is configured to display an option to select an increased haptic feedback mode.

27. The apparatus (100) of claim 26, when dependent on claim 22, wherein upon a fifth contact of the touchscreen, the apparatus (100) is configured to enter the increased haptic feedback mode where the haptic feedback provided by the haptic feedback unit (105) is increased when compared to the apparatus (100) not being in the increased haptic feedback mode.

28. The apparatus (100) of any one of claims 23 to 27, when dependent on claim 9, wherein upon the first contact, the transmitter (101a) is configured to not transmit data relating to a subset of the plurality of local elongated medical members (1001), and wherein upon the second contact, the transmitter (101a) is configured to trans-UAB Inovatyvi medicina 30A-166 907- 32 - mit data relating to the subset of the plurality of local elongated medical members (1001).

29. The apparatus (100) of any one of the preceding claims, further comprising a rail (108, 109) configured to couple medical equipment to the apparatus (100) and / or a plurality of lifting legs configured to adjust a height of the apparatus (100).

30. A system (3000) for manipulating a remote elongated medical member (2001) comprising: the apparatus (100) according to any one of the preceding claims when dependent on claim 8; and an external device (2000) comprising or being coupled to the remote elongated medical member (2001), and wherein the external device further comprises or is coupled to a transceiver (2002) configured to receive the first control signal.

31. The system (3000) of claim 30, wherein the transmitter (101a) is configured to transmit the first control signal to the transceiver (2002) of the external device (2000), wherein the first control signal comprises information on the manipulation of the local elongated medical member (1001), wherein the apparatus (100) is located in a first location and the external device (2000) is located at a second location, wherein the first and second locations are different locations.

32. The system (3000) of claim 31, wherein the transceiver (2002) of the external device (2000) is configured to receive the first control signal and the external device (2000) is configured to manipulate the remote elongated medical member (2001) based on the received first control signal.

33. The system (3000) of claim 32, wherein the remote elongated medical member (2001) is configured to be manipulated according to a third factor of a corresponding manipulation of the local elongated medical member (1001).

34. The system (3000) of any one of claims 30 to 33, wherein the control unit (101) further comprises a receiver (101b), wherein the control unit (101) is configured to receive, via the receiver (101b), a second control signal from the transceiver (2002) of the external device (2000), wherein the second control signal comprises information on the remote elongated medical member (2001).UAB Inovatyvi medicina 30A-166 907- 33 -35. The system (3000) of claim 34, wherein the haptic feedback provided to the user, by the haptic feedback unit (105), of the apparatus (100) is based on the received second control signal.

36. The system (3000) of claim 34 or 35, when dependent on claim 7, wherein the gripping unit (1002) of the apparatus (100) is moveable and / or rotatable based on the received second control signal.

37. The system (3000) of any one of claims 30 to 35, when dependent on claim 8, wherein there is an external device (2000) for each one of the plurality of local elongated medical members (1001).

38. The system (3000) of any one of claims 30 to 36, wherein the transceiver (2002) of the external device (2000) is configured to receive the first control signal and the external device (2000) is configured to manipulate the plurality of remote elongated medical members (2001) based on the received first control signal.

39. The system (3000) of any one of claims 34 to 38, when dependent on claim 8, wherein the apparatus (100) further comprises a plurality of haptic feedback units (105) configured to provide haptic feedback to the user of the apparatus (100) based on the received second control signal, wherein each of the plurality of haptic feedback units (105) is couplable to a different one of the plurality of local elongated medical members (1001).

40. The system (3000) of any one of claims 34 to 39, when dependent on claim 12, wherein at least one of the plurality gripping units (1002) of the apparatus (100) is moveable and / or rotatable based on the received second control signal.

41. The system (3000) of any one of claims 30 to 40, wherein the second parameter comprises a distance the remote elongated member (2001) has been manipulated and / or a rotational angle through which the remote elongated member (2001) has been manipulated, from a predetermined position and / or a force exerted on the remote elongated medical member (2001).

42. The apparatus (100) of any one of claims 30 to 41, when dependent on claim 15, wherein, when the limit of the second parameter has been reached, the haptic feedback unit (105) of the apparatus (100) is configured to provide a haptic feed-UAB Inovatyvi medicina 30A-166 907- 34 - back signal to the user indicating that the limit has been reached, wherein the limit is a movement limit of the remote elongated medical member (2001) and / or a force applied to the remote elongated medical member (2001).

43. An apparatus (100) for manipulating a local elongated medical member and a remote elongated medical member, the apparatus (100) comprising: a control unit (101) comprising a transmitter (101a); a sensing unit (1003) configured to sense a first parameter of the manipulated local elongated medical member (1001); and a haptic feedback unit (105) configured to provide haptic feedback to a user of the apparatus (100) based on the first parameter.

Images