Device and method for establishing an anchorage in tissue

1. A method for establishing an anchorage in tissue with the aid of mechanical vibration and a material which is liquefiable by mechanical vibration, the method comprising the steps of:

providing an opening in the tissue,

providing a perforated sheath adapted to the tissue opening and having a sheath axis, and an inner cross section and an outer cross section,

providing a tool comprising a vibrating element having a proximal end suitable for being connected to a vibration source and being capable of transmitting vibration generated by the vibration source to a distal portion of the vibrating element, and a counter element, wherein a distal portion of the vibrating element and a distal portion of the counter element have a cross section being adapted to the inner cross section of the sheath to allow introduction of these distal portions into the sheath, wherein the distal portion of the counter element comprises an axial passage and a distally facing end face and the vibrating element comprises a proximal shaft portion that extends through the axial passage of the counter element and is adapted for axial movement therein and a distal foot piece mounted to the shaft portion, the distal foot piece defining a proximally facing foot piece end face, and wherein the material which is liquefiable by mechanical vibration is present at an interface between the distally facing end face and the proximally facing foot piece end face,

positioning the sheath in the tissue opening,

connecting the proximal end of the vibrating element to the vibration source and positioning a distal end of the tool into the sheath with the interface between the vibrating element and the counter element situated in a region of a sheath perforation,

compressing the material which is liquefiable by mechanical vibration at the interface between the vibrating element and the counter element and transmitting mechanical vibration to the distal end of the vibrating element for a time sufficient to liquefy part of the liquefiable material at the interface between the vibrating element and the counter element and to make the liquefied material flow from the interface through the sheath perforation to penetrate the tissue and/or a space between the tissue and the sheath, and

removing the tool from the sheath.

2. The method according to claim 1 , wherein for keeping the inner space of the sheath substantially free of the liquefiable material, the cross section of the distal end of the tool is substantially the same as the inner cross section of the sheath.

3. The method according to claim 1 , wherein, before the step of removing, the distal end of the tool is axially displaced within the sheath for positioning the interface at a further anchoring location where a further anchorage is established.

4. The method according to claim 1 , wherein, in the step of compressing and transmitting, the interface is kept at a stationary position relative to the sheath.

5. The method according to claim 1 , wherein the mechanical vibration has a frequency of between 2 and 200 kHz.

6. A method for establishing an anchorage in tissue with the aid of mechanical vibration and a material which is liquefiable by mechanical vibration, the method comprising the steps of:

providing an opening in the tissue,

providing a perforated sheath adapted to the tissue opening and having a sheath axis, and an inner cross section and an outer cross section,

providing a tool comprising a vibrating element having a proximal end suitable for being connected to a vibration source and being capable of transmitting vibration generated by the vibration source to a distal portion of the vibrating element, and a counter element, wherein a distal portion of the vibrating element and a distal portion of the counter element have a cross section being adapted to the inner cross section of the sheath to allow introduction of these distal portions into the sheath, wherein the distal portion of the counter element comprises an axial passage and the vibrating element comprises a proximal shaft portion that extends through the axial passage of the counter element and is adapted for for axial movement therein, and wherein the material which is liquefiable by mechanical vibration is present at an interface between a distally facing end face of the counter element and a proximally facing foot piece end face of the vibrating element,

positioning the sheath in the tissue opening,

connecting the proximal end of the vibrating element to the vibration source and positioning a distal end of the tool into the sheath with the interface between the vibrating element and the counter element situated in a region of a sheath perforation,

compressing the material which is liquefiable by mechanical vibration at the interface between the vibrating element and the counter element and transmitting mechanical vibration to the distal end of the vibrating element for a time sufficient:

to liquefy part of the liquefiable material at the interface between the vibrating element and the counter element to yield liquefied material, and

to make the liquefied material flow from the interface through the sheath perforation to penetrate the tissue and/or a space between the tissue and the sheath, and

removing the tool from the sheath.

7. The method according to claim 6 , wherein for keeping the inner space of the sheath substantially free of the liquefiable material, the cross section of the distal end of the tool is substantially the same as the inner cross section of the sheath.

8. The method according to claim 6 , wherein, before the step of removing, the distal end of the tool is axially displaced within the sheath for positioning the interface at a further anchoring location where a further anchorage is established.

9. The method according to claim 6 , wherein, in the step of compressing and transmitting, the interface is kept at a stationary position relative to the sheath.