DE10162933A1 - Device for extracting tissue in spinal column surgery comprises a hollow shaft having a separating mechanism for removing and introducing tissue and an operating unit - Google Patents

Abstract

Device comprises a hollow shaft (1) having a separating mechanism (2) in a front section for removing and introducing tissue into the shaft and an operating unit (3) in the rear section for operating the separating mechanism, and a transport element (4) mechanically driven by a drive (5) on or in the shaft or a rinsing unit for transporting removed tissue within the shaft from the front section into the rear section. Preferred Features: The transport element is formed as a slidable block having a carrier for the removed tissue or as a screw conveyor in the hollow shaft. The rinsing unit has a channel running from the front to the rear with a nozzle directed into the shaft.

Description

Technical application area

The present invention relates to a Device for tissue extraction with a hollow shaft, the one in a front area a separation mechanism for separating and inserting tissue into the Hollow shaft and one in a rear area Actuating device for actuating the separating mechanism having.

In some medical specialties, such as spine surgery, must be done at different Intervened pieces of tissue from the area of the spine be removed. An example of this is the Posterior Lumbar Interbody Fusion (PLIF) at the Spine in the area of the ligamentum flavum decompression through targeted tissue extraction and the insertion of a cage can be performed. The Tissue removal is done with a rongeur who is at the Tip a separating mechanism to separate and Has bone tissue absorption.

State of the art

When handling such a rongeur leads the surgeon the tip of this instrument with the integrated separation mechanism to those for the Tissue removal provided and actuated via one located at the proximal end of the rongeur Actuator the separation mechanism. hereby tissue is separated from the bone and into one Cavity added at the top of the rongeur. In the As a rule, the rongeur must be switched off after each cutting process removed the surgical opening and that in it Any tissue that has been removed is manually cleared become. By constantly removing the rongeur however, the operating field becomes concentration interrupted by the surgeon. Continue to extend this repeated process and the associated Cleaning operations the duration of an operation.

To improve this situation is out of US 6,142,997 a rongeur known to be on top Larger volume for detached tissue having. With this configuration, the surgeon can several separation steps at the surgical site perform before the rongeur is removed and the severed Tissue must be removed. The publication also discloses an embodiment of a rongeur in which the separated tissue with the help of an attached Vacuum pump over a hollow shaft of the rongeur during the operation is automatically removed. This However, design is for practical use not practicable because they are highly adhesive Tissue for a rapid blockage of the hollow shaft leads.

Based on this state of the art Object of the present invention in that Specify tissue extraction device that the Surgeon's work is facilitated and shortened Duration of surgery.

Presentation of the invention

The task is accomplished with the device Claim 1 solved. Advantageous configurations the device are the subject of the dependent claims.

The present device has a hollow shaft on that in a front area with a Separation mechanism for separating and inserting tissue into the hollow shaft and in the rear area with a Actuator for the actuation of the Separation mechanism is equipped. On or in the hollow shaft a mechanical driven by a drive Transport element or a flushing device for transporting separated tissue within the hollow shaft of the arranged in the front area in the rear area.

Through this embodiment of the present The device becomes an automated material transport within the hollow shaft from the surgical site to allows proximal end of the device. The Device must remove the separated Tissue no longer from the surgical field be taken out. Especially with the above Spinal surgery becomes the operating time, especially the decompression process, considerably shortened. The surgeon's concentration will not through previously necessary cleaning processes interrupted. The means for the automatic Material transport in the form of a mechanical transport element or a flushing device that has a very high force can ensure a complete Material transport through the hollow shaft. The one with these Forces that can be generated by means of the device are simply sufficient around the still moist and therefore strongly adhesive material from the front to the rear end of the hollow shaft transport.

The present device is preferably in the With regard to the separation mechanism as well as the Actuator like a conventional one known Rongeur built up. In addition, the shaft is this Rongeurs with a hollow channel, i.e. H. as a hollow shaft trained, the on or in the hollow shaft Device for automatic material transport with the mechanical transport element or the flushing device is integrated.

The mechanical transport element can be in one advantageous embodiment of the present Device as inside the hollow shaft slidable slide be formed, the at least one Has carrier for the separated tissue. The Is sledged by a in the back of the Hollow shaft, preferably on the rear, d. H. proximal end, arranged drive between the front and back moves back and forth. When the separation mechanism is actuated by the Operator is the carriage on the front, d. H. distal end, leaving the severed tissue behind pressed the driver arranged on the slide and after the closing movement of the separation mechanism with the Slide to the rear end of the hollow shaft is transported. Then the moves Sled, driven by the drive, back into the front position.

In a further advantageous embodiment of the present device is the mechanical one Transport element in the form of a screw or Screw conveyor formed in the hollow shaft. The screw or Snail picks up due to its drive generated rotary motion when disconnected in the Hollow shaft came with and transports tissue through the rotary movement in the rear area of the Hollow shaft. The worm or screw can do this continuously or only when the Separation mechanism are driven.

In this embodiment, the screw or Screw conveyor also part of the Form separation mechanism. Here the screw or Snail in the front area with a cut edge provided that with a rotary movement with a provided the front area of the hollow shaft Counter surface interacts to turn through to separate the tissue present at this point.

It goes without saying that the Separation mechanism possible in a known manner, in which on Hollow shaft two slidable against each other Components, such as jaws, are formed that at a closing movement in which both jaws are on top of each other butt, close an opening in the hollow shaft and from which at least one has a cut edge for severing of the fabric when the closing movement is carried out having. One of these jaws can be replaced by a counter surface formed by the hollow shaft itself against which the other jaws are formed along the hollow shaft is displaceable.

In one configuration of the transport device as a rinsing device is at least one from the rear Area to the front area of the hollow channel at or in this running channel for a rinsing liquid at least one in the front area in the hollow shaft directional nozzle provided through which a liquid Medium for the transport of the separated tissue under Pressure can be introduced into the hollow shaft. By leave a pulsed mode of operation of this flushing medium very high forces are generated in the hollow channel, which for reliable transport of the separated tissue into the back of the hollow shaft.

That in the back of the hollow shaft transported tissue can pass through an opening either be removed manually or via a corresponding transport line to a collection container or fed to a device for further processing become. The opening is preferably at the end of the hollow shaft, but can also be on the side Hollow shaft can be arranged. In one embodiment of the present device is in the rear of the Hollow shaft a device for rinsing the separated tissue from the back area or the transport element located in the rear area intended. Such a flushing device is automated the removal of the severed tissue, so that too this process can no longer be done manually got to. In addition to a flushing device, there is also one mechanical transport device for removing the severed tissue from the present device possible, for example, by the separated tissue in special sleeves are transported to the rear end, which then continues via a designated pipeline be transported.

In a further advantageous embodiment of the The present device is in the front area of the A light source for illuminating the hollow shaft Integrated instrument tip. This light source is preferably formed by an optical waveguide, which extends from the rear of the hollow shaft to extends the front area and in the rear area with an appropriate lighting device connected is. This configuration leads to a better lighting of the surgical site in the Usually with a headlamp worn by the surgeon is not so easily accessible. This will make the Perception improved and the intervention more comfortable and designed safer. On a headlamp can with the present embodiment of the device to be dispensed with.

In a further advantageous embodiment of the The present device is with a separator for the separation of inhomogeneous tissue, in particular for separating soft tissue and cartilage tissue from Bone tissue, connected. This connection can, for example. be realized via a transport or flushing line.

Such an embodiment of the device enables the provision of already separated Bone tissue for further use during the Operation, for example for pressing into a cage. The Separator consists of one container, one in it Container used membrane, an actuator as well Means for mechanical separation of at least one first of at least a second type of fabric of the inhomogeneous tissue. The in the container The membrane used divides the inner volume of the Container in two partial volumes. The actuator is with connected to a corresponding drive that this while maintaining a gap between the membrane and actuator moves across the membrane to enter the container introduced inhomogeneous tissue over the membrane to brush.

The separator thus uses a means for mechanical separation of the first from the second Type of tissue, in particular of cartilage and / or soft tissue of bone tissue, in connection with a membrane that is permeable to the first type of fabric and is impervious to the second type of fabric. at a supply of inhomogeneous tissue in the actuator having first partial volume of the container and one operation of the actuator thus collects the first Type of tissue in the other partial volume. The second Tissue type can be taken from the first partial volume or via a corresponding opening in the container, which is connected to the first partial volume become.

As a means of mechanically separating the first The second type of fabric can be different Use mechanisms, also in combination. Preferably this means through a roughened surface the membrane and / or the actuator formed so that by stroking the inhomogeneous tissue over the roughened surface of the membrane a mechanical Separation of the first from the second type of fabric, comparable to a peeling process. Just the separation of the soft tissue from bone tissue can be achieved by using a membrane with a Realize roughened surface very advantageously. A roughening of the actuator is not in everyone If necessary, so too the problem of Adhesion of the tissue to the actuator is avoided.

In addition to a roughened surface of the membrane can also with the present separator Water jet nozzles or ultrasonic transmitters in or on the Container and / or the actuator to be arranged mechanical separation of the first from the second To achieve tissue type. The water jet nozzles are dimensioned and aligned in such a way that their mechanical action is the first of the second Separate tissue mechanically. In the case of separation from Cartilage and soft tissue are separated from the bone tissue the flow properties and the water pressure are suitable chosen that the cartilage and soft tissue from Bone tissue washed off and rubbed against the membrane without destroying the bone tissue. The Water pressure presses the detached cartilage and Soft tissue through the membrane into the other Partial volume.

When using the ultrasonic separation technology, the Ultrasound source at specific frequencies of the Cartilage or soft tissue adjusted, for example Resonant frequencies. The ultrasound movements just shred those two types of tissue, which then by moving the actuator through the membrane into the other partial volumes are discharged. The actuator too itself can be here by suitable design as Serve ultrasound source.

Basically, the gap distance between the Actuator and membrane selected such that the tissue through the relative movement between these two Components is not damaged. With separation softer pieces of tissue from a hard bone core becomes the actuator with the optimal speed moved so that the rubbed turnout through this Movement through the membrane into the other partial volume be pressed.

To maintain a defined gap distance the shape of the actuator must of course match the shape be adapted to the membrane - or vice versa. The The membrane itself can form a flat surface, the actuator in this case, for example, in the form of a Slider can be formed.

In an advantageous embodiment, the Membrane almost bowl-shaped or funnel-shaped formed and the actuator has the shape of one Longitudinal axis rotatable body of rotation in the partial volume enclosed in a ring by the membrane is driven in rotation.

Brief description of the drawings

The present device is as follows based on exemplary embodiments without limitation of general inventive concept based on the drawings again briefly explained. Here show:

Fig. 1 shows a first example of the embodiment of the present apparatus;

FIGS. 2a-d is an exemplary illustration of the operation of the apparatus shown in FIG. 1;

FIG. 3 shows another example of an embodiment of the present apparatus;

FIG. 4 shows another example of an embodiment of the present apparatus;

FIG. 5 shows three exemplary embodiments of the release mechanism of the present apparatus;

Figure 6 is an example of an embodiment of the device in connection with other components for further processing of the severed tissue.

FIG. 7 shows an example of the configuration of a separator for the separation of inhomogeneous tissue;

Fig. 8 is an example of a cage press; and

Fig. 9 shows an example of an embodiment of the present device with integrated lighting device.

Ways of Carrying Out the Invention

Fig. 1 shows a first example of a possible embodiment of the present apparatus for extracting tissue, particularly bone tissue from a surgical site. The device has a hollow shaft 1 , at the front end of which a separating mechanism 2 for separating and inserting tissue into the hollow shaft 1 is formed. In this example, the separating mechanism is formed by two jaws 7 which can be moved relative to one another. One of these jaws is formed by the lower boundary of the hollow shaft 1 , the other by a counterpart which can be moved along the hollow shaft. This counterpart is moved by a certain distance forwards or backwards by an actuating device 3 arranged at the rear end of the hollow shaft 1 , so that either an opening, the so-called cutting chamber 8 , to the hollow shaft 1 is opened or closed. The displaceable part has a cutting edge 9 in order to be able to cut off corresponding tissue when the jaws 7 are closed. The separated tissue is thereby taken up in the hollow shaft 1 and transported to the rear by a carriage 4 shown in this illustration in the rear region of the hollow shaft 1 . The carriage 4 is driven by a corresponding motor 5 at the rear end of the hollow shaft 1 . The carriage 4 has a driver 6 for the separated tissue.

When the jaws 7 are opened, the carriage 4 is located in the front region below the opening 8 that is thereby opened. When the jaws 7 are closed , the tissue is introduced into the slide 4 and automatically transported into the rear region of the hollow shaft 1 by means of the motor 5 . The tissue can then be removed from the slide 4 there. This can be done, for example, by means of a device for rinsing out the carriage 4 , so that the tissue can thereby be automatically rinsed out and discharged via a corresponding line, not shown in this figure.

FIGS. 2a-d show the different stages of the operation of this apparatus in detail again. Fig. 2a shows in this case the tip of the hollow shaft 1 with opened jaws 7. In this open position, the device is placed on the tissue to be separated. The carriage 4 is located in the opening. The jaws 7 are then closed by actuating the actuating device. As a result of this closing, the tissue is separated and pressed into the slide 4 . After the jaws 7 have been closed, the slide 4 is transported backwards by the drive via the hollow shaft 1 , as indicated by the arrow in FIG. 2b. Fig. 2c shows this transport of the carriage 4 again omitting the cover of the hollow shaft 1. After the tissue has been transported into the rear region of the hollow shaft 1 , it can be removed by rinsing ( FIG. 2d).

Fig. 3 shows another embodiment for the realization of the present device. In this exemplary embodiment, the individual components of which otherwise correspond to the exemplary embodiment in FIG. 1, the transport element 4 is designed as an Archimedesian screw which is rotated by the motor 5 . The separation mechanism 2 is configured in this example as already explained in connection with FIG. 1. By the rotation of the worm 4 Archimedes'schen the captured by the hollow shaft 1 material is transported into the rear portion of the hollow shaft 1 and can be automated there manually removed or.

FIG. 4 shows an example of an embodiment of the present device, in which a rinsing device 10 is provided in the rear region of the hollow shaft 1 for rinsing out the separated tissue. By means of this rinsing device 10 , the separated tissue transported backwards by the transport mechanism is automatically rinsed out of the hollow shaft 1 or the transport means and transported away via a correspondingly connected feed and discharge line 13 . This feed and discharge line 13 can be connected, for example, to a collecting container or a separator for separating the bone tissue from soft and cartilage tissue.

Fig. 5 shows three exemplary embodiments of the separation mechanism 2 of the present apparatus.

In partial view A, this separating mechanism is formed by a slide 7 which is pushed over the cutting chamber 8 in the direction of the arrow. The tissue is cut off by the cutting edge 9 on the slide 7 and the further cutting edge 9 formed by the edge of the hollow shaft 1 .

Partial view B shows an embodiment in which, when the screw 4 rotates as a mechanical transport element, the tissue is cut off by the interaction of the cutting edge 9 of the hollow shaft 1 with a cutting edge 9 on the screw 4 and simultaneously transported into the hollow shaft 1 .

In partial view of an embodiment of the separation mechanism C is finally shown, in which the designed as a carriage or slide mechanical transport element 4 having a cut edge. 9 When the slide or slide 4 moves in the direction of the arrow, the tissue is separated by the interaction of the cutting edge 9 on the slide or slide 4 with the cutting edge 9 on the hollow shaft 1 .

FIG. 6 shows an embodiment of the present device in which it is connected to a separator 14 for separating the tissue. The figure schematically shows the present device with the hollow shaft 1 and the separating mechanism 2 provided in the front area. By actuating the actuating device 3 , a part is separated from a schematically represented tissue region 15 , for example during an operation on the spine, by the separating mechanism 2 and in the hollow shaft 1 via the transport mechanism 4 , which is schematically represented by the arrow, in the rear region of the Hollow shaft 1 transported. In this illustration, a light source 11 is additionally arranged in the front area of the hollow shaft 1 in order to illuminate the surgical site. The separated tissue transported to the rear is fed via a flushing line 13 to a separator 14 in which the mixed, inhomogeneous tissue, consisting of bone material, soft tissue and cartilage tissue, is separated. In particular, the bone tissue in the separator 14 is separated from the remaining tissue and fed to a cage press 17 via a further transport line 16 . The bone tissue in the cage 18 is compressed in this cage press 17 , into which a cage 18 is inserted. The cage 18 filled with the bone tissue is then used again in the further course of the operation at the separated point of the spine.

By designing the present device in connection with a separator 14 and possibly a cage press 17 , numerous steps, in particular the removal of the separated tissue and the separation of the tissue, are automated and thus relieve the operator.

FIG. 7 shows an example of a separator 14 , as can be used with the present device, for example. The device consists of a container 19 with an internal volume, into which a bowl-shaped membrane 20 is inserted in the present case. The membrane 20 divides the inner volume of the container 19 into two partial volumes, in the present case an upper and a lower partial volume. The container 19 has a bottom-side central outlet 21 , which is connected to a bottom-side opening 22 of the membrane 20 via a connecting channel. The bottom-side central opening 22 is suitably sealed from the lower partial volume of the container 19 .

The membrane 20 , which can also have the function of a sieve, is designed or selected such that it allows soft tissue or cartilage tissue to pass through, but is impermeable to bone parts.

An actuator 23 is arranged within the upper partial volume and can be driven to rotate about a longitudinal axis 24 . The corresponding drive cannot be seen in this figure. The actuator 23 is designed in such a way that it maintains a defined gap distance 25 from the inner surface of the membrane 20 both in the idle state and also during the rotation. The container 19 is closed during operation, inhomogeneous tissue, in the present example consisting of bone, cartilage and soft tissue, being fed via appropriately provided feeders 26 over the edge of the membrane 20 into the gap 25 between the membrane 20 and the actuator 23 . The shape of the gap 25 is designed such that the inserted tissue is transported further in the direction of the outlet opening 21 at the bottom of the container 19 when the actuator 23 rotates in cooperation with the gravitation. In this example, the membrane 20 is roughened on its inner surface facing the actuator 23 such that the cartilage and soft tissue is peeled from the bone tissue by the transport of the tissue within the gap 25 . As a result of this separation in the gap 25 , the peeled cartilage and soft tissue is separated through the membrane 20 into the lower partial volume of the container during the flow, so that only the healthy bone tissue remains at the outlet opening 21 . This bone tissue can be washed out, for example, with autologous blood for further processing or storage.

To support the separation process, a liquid can be poured into the container 19 , in which the soft tissue or cartilage tissue is detached from the bone or is completely dissolved. Due to the simultaneous mechanical circulation in the gap 25 by rotation of the actuator 23 , the detached tissue is separated into the lower partial volume.

For the erosive separation by the roughened surface 27 of the membrane 20 , the rotational speed of the actuator 23 is set in such a way that the abraded materials are pressed through the membrane 20 into the lower partial volume.

FIG. 8 shows an example of a cage press 17 as can be used in connection with FIG. 6. Cage press 17 consists of a holder 28 for a cage 18 , which can be designed in the form of a die. A press device with a stamp 29 is arranged above this holder 28 . The pressing device presses the plunger 29 downwards into a cage 18 with bone material inserted into the holder 28 by means of a linear feed movement. The pressing device is preferably driven by a motor 30 .

When this cage press is operating, an empty cage 18 is placed in the holder 28 . The separated bone tissue is then placed in the cage 18 . The quantity can be checked, for example, by weight measurement or a marking on the holder 28 . Finally, the device is actuated by actuating the motor 30 , so that the stamp 29 presses the bone tissue into the cage 18 with a defined pressure. The filled cage 18 can then be removed from the holder 28 and used for further use.

In a further development of this cage press 17 , a gas supply is additionally provided within the holder 28 or the stamp 29 in order to achieve a better cancellous structure of the solidified bone material in the cage. For this purpose, the gas is pressed into the cage 18 under defined pressure during the pressing process.

Fig. 9 shows an embodiment of the present device is arranged in which a light source 11 in the front region of the hollow shaft 1. In the present example, this light source 11 is formed by an optical waveguide 12 which extends from the rear region of the hollow shaft 1 on the hollow shaft to the front region in order to illuminate well the surgical site, ie the location at which tissue is to be separated. The other end of the optical waveguide 12 is connected to a corresponding lighting device through which the required light output is coupled into the optical waveguide 12 . LIST OF REFERENCES 1 hollow shaft
2 separation mechanism
3 actuating device
4 mechanical transport element
5 drive / motor
6 drivers
7 sliding jaws
8 opening / cutting chamber
9 cutting edge
10 rinsing device
11 light source
12 optical fibers
13 Inlet and outlet line
14 separator
15 tissue area
16 transport line
17 Cage press
18 Cage
19 container
20 membrane
21 outlet
22 bottom opening of the membrane
23 actuator
24 longitudinal axis of the actuator
25 gap
26 feeders
27 surface of the membrane
28 Bracket for cage
29 stamps
30 engine

Claims (23)

1. Device for tissue extraction with a hollow shaft ( 1 ), which has a separating mechanism ( 2 ) for separating and inserting tissue into the hollow shaft ( 1 ) in a front area and an actuating device ( 3 ) for actuating the separating mechanism in a rear area ( 2 ), characterized in that on or in the hollow shaft ( 1 ) a mechanical transport element ( 4 ) which can be driven by a drive ( 5 ) or a rinsing device for transporting separated tissue within the hollow shaft ( 1 ) from the front to the rear area is arranged , 2. Device according to claim 1, characterized in that the mechanical transport element ( 4 ) is designed as a displaceable slide which has at least one driver ( 6 ) for the separated tissue. 3. Device according to claim 1, characterized in that the mechanical transport element ( 4 ) is designed as a screw or screw conveyor in the hollow shaft. 4. The device according to claim 1, characterized in that the rinsing device has a channel extending from the rear to the front region with at least one nozzle directed into the hollow shaft ( 1 ) in the front region, through which a liquid medium for the transport of the separated tissue under pressure can be introduced into the hollow shaft ( 1 ). 5. Device according to one of claims 1 to 4, characterized in that the separating mechanism ( 2 ) is formed by two mutually displaceable components ( 7 ) which, during a closing movement in which both components ( 7 ) meet, an opening ( 8 ) close in the hollow shaft ( 1 ) and at least one of which has a cutting edge ( 9 ) for severing the tissue when the closing movement is carried out. 6. The device according to claim 3, characterized in that the separating mechanism ( 2 ) is formed by a cutting edge ( 9 ) formed on the screw or screw conveyor in the front region in cooperation with a counter component formed on the hollow shaft ( 1 ), so that upon rotation the screw or screw conveyor between the cutting edge ( 9 ) and the counter-component tissue is separated. 7. Device according to one of claims 1 to 6, characterized in that an electric drive at the rear end of the hollow shaft ( 1 ) is provided as the drive ( 5 ). 8. Device according to one of claims 1 to 7, characterized in that in the rear region of the hollow shaft ( 1 ) a device ( 10 ) for rinsing the separated tissue from the rear region of the hollow shaft ( 1 ) and / or the transport element ( 4 ) is arranged. 9. Device according to one of claims 1 to 8, characterized in that a light source ( 11 ) is integrated in the front region of the hollow shaft ( 1 ). 10. The device according to claim 9, characterized in that the light source ( 11 ) is formed by an optical waveguide ( 12 ) which leads on or in the hollow shaft ( 1 ) from the rear area to the front area. 11. The device according to one of claims 1 to 10, which is connected via a rinsing line ( 13 ) to a separator ( 14 ) for separating inhomogeneous tissue, into which the separated tissue is transported. 12. The device according to claim 11, characterized in that the separator ( 14 ) consists of a container ( 19 ) with an internal volume through a membrane ( 20 ) inserted into the container ( 19 ), which is permeable to at least a first type of fabric , is subdivided into two sub-volumes, an actuator ( 23 ) which moves over the membrane ( 20 ) while maintaining a gap distance ( 25 ) between the membrane ( 20 ) and the actuator ( 23 ) in order to introduce into the container ( 19 ) Brushing tissue over the membrane ( 20 ) and assembling means for mechanically separating the first from at least one second type of tissue. 13. The apparatus according to claim 12, characterized in that the means for mechanical separation are formed by a roughened surface ( 27 ) of the membrane ( 20 ) and / or the actuator ( 23 ). 14. The apparatus according to claim 12 or 13, characterized in that the means for mechanical separation are formed by water jet nozzles arranged in the container ( 19 ) and / or actuator ( 23 ). 15. The apparatus according to claim 12 or 13, characterized in that the means for mechanical separation are formed by on or in the container ( 19 ) and / or actuator ( 23 ) arranged ultrasonic transmitter. 16. Device according to one of claims 12 to 15, characterized in that the container ( 19 ) is designed closable, so that the internal volume or a partial volume thereof can be kept during the separation under a predetermined pressure and / or a predetermined temperature. 17. Device according to one of claims 12 to 16, characterized in that the actuator ( 23 ) is designed as a slide. 18. Device according to one of claims 12 to 16, characterized in that the actuator ( 23 ) is designed as a rotary body rotatable about a longitudinal axis ( 24 ) which rotates when driven in a partial volume which is annularly surrounded by the membrane ( 20 ). 19. Device according to one of claims 12 to 17, characterized in that the membrane ( 20 ) forms a flat surface. 20. Device according to one of claims 12 to 18, characterized in that the membrane ( 20 ) is approximately bowl-shaped or funnel-shaped. 21. The apparatus according to claim 20, characterized in that the container ( 19 ) has a bottom-side outlet opening ( 21 ) into which the membrane ( 20 ) opens. 22. Device according to one of claims 12 to 21, characterized in that a device ( 17 ) for pressing separated bone tissue into a cage ( 18 ) is provided, which has a holder ( 28 ) for inserting the cage ( 18 ) and a the holder ( 28 ) has a pressing device with a stamp ( 29 ). 23. The device according to claim 22, characterized in that the holder ( 28 ) and / or the plunger ( 29 ) are equipped with a gas supply, via which a gas can additionally be pressed into the cage ( 18 ) during the pressing process.