Medical applicator and procedure for loading a medical applicator

Abstract

The invention relates to a medical applicator (10) for applying an agent, comprising a base body (12), a shaft (14) arranged on the base body (12), wherein the base body (12) and the shaft (14) form a channel (16) extending through the base body (12) and the shaft (14) through which the agent can be supplied to an application site, a plunger (18) that can be inserted into the channel (16) to apply the agent, an actuating element (20) that is guided and movable on the base body (12), and a receiving space (22) formed by the base body (12) and / or the actuating element (20) and configured to receive the agent, wherein the actuating element (20) can be brought into an application position by a relative movement to the base body (12), and wherein the receiving space (22) is moved by the relative movement between the actuating element and the receiving space (22). (20) and the basic body (12) can be reduced in size,and wherein the medium introduced into the receiving chamber (22) can be directed to the channel (16) by reducing the size of the receiving chamber (22).

Description

[0001] The present invention relates to a medical applicator for applying an agent and a method for loading a medical applicator.

[0002] Cartilage is an important tissue in the human body, playing a key role in the movement and stability of joints. However, it is susceptible to wear and tear and injury. As a result of injury or diseases such as arthritis, cartilage can break down, leading to joint damage and, subsequently, pain, limited mobility, and other negative consequences.

[0003] Current methods for producing cartilage tissue substitutes and treating joint damage are complex and time-consuming, resulting in high costs and limited availability. Therefore, there is a need for a fast and efficient method to meet the demand for regenerative treatments.

[0004] The minced cartilage procedure represents a promising approach for the treatment of joint damage. The minced cartilage procedure is an innovative technique for treating joint damage that has gained increasing popularity in recent years. The procedure is frequently used in patients with cartilage damage in the knee joint, but can also be used to treat cartilage damage in other joints, such as the ankle or elbow.

[0005] The procedure involves using the patient's own cartilage tissue, which is removed from the affected joint. This cartilage is crushed into small pieces, and the pieces are then combined with the patient's platelets and growth factors, which are extracted from a blood sample, to create a cartilage concentrate. The concentrate is then applied to the damaged area of ​​the cartilage using a medical applicator to repair the damaged cartilage.

[0006] One of the main advantages of this method is that it is minimally invasive and can usually be performed on an outpatient basis. Compared to traditional surgical procedures for treating cartilage damage, the minced cartilage procedure is gentler on the patient and requires a shorter recovery time. Patients can typically regain mobility within a few weeks after the procedure.

[0007] Another important feature of the minced cartilage procedure is that it uses autologous materials. Since the cartilage tissue used comes from the patient's own body, there is no risk of rejection or infection. Unlike other procedures such as the use of synthetic implants or donor tissue grafts, this method carries no compatibility risks.

[0008] Special medical applicators are available for performing the minced cartilage procedure. These typically consist of a long, narrow shaft with a specially shaped end that can be adjusted to suit the size and shape of the affected joint. The end of the shaft has an opening and a small diameter. It is used to apply the concentrate to the damaged area of ​​the joint. To transport the concentrate through the shaft, the applicators often include a plunger that can be moved through the shaft. After an applicator has been inserted into the joint via an access point created during minimally invasive arthroscopy, the concentrate can be applied. To do this, the concentrate is pushed out of the end of the shaft and applied to the damaged area by gently pressing on the plunger of the applicator.

[0009] There are various methods for loading the concentrate into the applicator. For example, there are applicators whose proximal end of the shaft is open and designed for loading the concentrate. Other applicators have a loading window that opens towards a medial side of the applicator and through which the concentrate can be loaded into the shaft. After loading, the loading window must be closed with a lid in order to apply the concentrate using the plunger. In both cases, however, loading is not convenient, quick, efficient, or clean. For example, it is disadvantageous to have to place the lid on the loading window after loading. This can lead to contamination of the concentrate and / or soiling of an external surface of the applicator due to concentrate oozing out.Filling via the proximal end of the shaft can also lead to contamination of the concentrate, loss of volume, and / or contamination of the applicator. Furthermore, insertion is laborious because the concentrate must be introduced into a narrow channel.

[0010] For example, DE 20 2022 002 303 U1 discloses an applicator for applying transplants in surgery. The applicator has a handle with an extension through which a channel extends. The transplant is inserted into a receiving area of ​​the handle, which is then closed with a closure device. The transplant is then pushed through the channel by means of a plunger.

[0011] In addition, the documents DE 10 2007 059 385 A1, US 2015 / 0 045 768 A1 and DE 20 2022 002 294 U1 are relevant for the present application.

[0012] Based on the prior art, the object of the invention is to provide a medical applicator with great user-friendliness and high efficiency.

[0013] This object is achieved according to the invention by a medical applicator for applying an agent and a method for loading a medical applicator as described herein and defined in the claims.

[0014] The present invention provides a medical applicator for applying an agent. The applicator comprises a base body and a shaft arranged on the base body. The base body and the shaft form a channel that extends through the base body and the shaft and through which the agent can be delivered to an application site.In addition, the applicator comprises a plunger which can be pushed into the channel in order to apply the agent, an actuating element which can be moved in a guided manner on the base body, and a receiving space which is formed by the base body and / or the actuating element and which is designed to receive the agent, wherein the actuating element can be brought into an application position by a relative movement to the base body, wherein the receiving space can be reduced in size by the relative movement between the actuating element and the base body, and wherein agent introduced into the receiving space can be fed to the channel by reducing the receiving space.

[0015] Advantageously, this makes it possible to provide an applicator that is both user-friendly and highly efficient. The applicator can be loaded with the agent in a simple and efficient manner. Loading is faster and cleaner. This also prevents contamination of the agent. Furthermore, material loss can be reduced, which, for example, makes the costs of carrying out a treatment using an applicator more cost-effective. Advantageously, the agent can be introduced into the receiving space and, by reducing the size, fed into the channel. This makes the applicator particularly user-friendly. A user has a relatively large receiving space available for introducing the agent and can reduce this space when they wish to apply the agent. Furthermore, such an applicator is cost-effective to manufacture and essentially does not require any small or difficult-to-handle parts, such as a lid.The applicator according to the invention is cleaner and more efficient to use than conventional applicators. Firstly, there is a relatively large receiving space, which simplifies the introduction of the agent, and secondly, the agent can be supplied to the channel easily and efficiently by reducing the receiving space. In general, this also reduces the required installation space and provides an applicator that is cost-effective to manufacture.

[0016] The applicator can in particular be an applicator for applying an agent for performing the “minced cartilage” procedure. Furthermore, the applicator can also be suitable for performing other procedures. The applicator can be convertible and / or configured to perform other procedures. For example, the shaft can be designed to perform a specific procedure. This shaft can be provided for use with the applicator. Generally, the applicator is suitable for applying the agent. In this context, “applying” can mean applying, introducing, applying, injecting, and / or the like. For example, the agent can be applied to a defective area of ​​a joint. This area can be the application site. This can mean that the agent is injected and / or introduced into a joint space.Basically, during application, the agent is transported out of a distal end of the shaft, in particular to the application site.

[0017] The agent can in particular be a mixture of substances. The mixture of substances can in particular be a mixture of substances that is provided for carrying out the “minced cartilage” method. This can mean, for example, that the agent comprises pieces of tissue, in particular pieces of cartilage tissue, preferably from the patient to whom the agent is to be applied. Furthermore, the agent can comprise components of the patient’s blood. The agent can also be a homogeneous or heterogeneous agent. Furthermore, the agent can comprise multiple phases. In particular, the agent can comprise solids and / or solid-like phases and / or pieces. In addition, the agent can comprise at least one liquid and / or aqueous phase. Furthermore, the agent can be compressible. This can mean that a volume of the agent can be reduced. For this purpose, the agent can comprise at least one compressible component.For example, the tissue pieces, especially the cartilage pieces, can be compressible. This can mean that the tissue pieces, especially the cartilage pieces, can be pressed and / or compressed.

[0018] The base body can define a part, in particular a large part, of the outer surface of the applicator. For example, the base body can define 20% - 100%, in particular 40% - 90%, preferably 60% - 80%, of the outer surface of the applicator. Furthermore, the base body can be intended to be held by a user. This can mean that the base body is intended to be held by the user during application. For this purpose, the base body can have an ergonomic shape. This can mean, for example, that the base body has external dimensions such that the user can hold the base body, in particular the applicator, with one hand. In general, the base body can define a main body of the applicator. The appearance of the applicator that is perceptible to the human eye can be significantly defined by the base body.In addition, the base body can be easily cleaned, disinfected, and / or autoclavable. It can also be provided that the base body and / or the entire applicator is / are intended for single use. Furthermore, the base body can extend at least substantially along a main extension direction. A "main extension direction" of an object is understood to mean, in particular, a direction that runs parallel to a longest edge of the smallest imaginary cuboid that just completely encloses the object and that preferably runs through a geometric center and / or a center of mass of the component.

[0019] The shaft can be elongated and / or extend at least substantially along the main extension direction of the base body. The shaft can extend at least partially from a distal end of the base body in the distal direction along the main extension direction of the base body. Furthermore, the shaft can be rod-shaped and / or tubular. This can mean that an outer diameter of the shaft is small in relation to the length of the shaft. Preferably, the shaft is designed to be inserted into a patient's body, in particular for administering the agent. The shaft can be hollow-cylindrical and / or comprise an opening at its distal end through which the agent can be conveyed out of the shaft. In particular, the opening can be brought into close proximity to the application site for application such that the agent can be delivered to the application site.In this context, feeding can mean applying.

[0020] The application site can be located, in particular, within a patient's body, in particular within a knee. The application site can be a defect, in particular a defect in cartilage tissue. The shaft can be partially arranged within the base body. In particular, the base body can have a shaft mounting recess into which the shaft is mountable and / or mounted. The shaft can be arranged, in particular, detachably on the base body. In some embodiments, the shaft is adhesively bonded to the base body. The shaft can be replaceable and / or configured specifically for a patient's anatomy and / or a specific action. For example, the shaft can have a bend in a distal end region of the shaft.The bend can be designed such that the agent can be dispensed from the shaft at an angle of, for example, 0° to 120°, in particular 5° to 90°, preferably 10° to 70° and particularly preferably 10° to 45°. Furthermore, the shaft can have a different length depending on the application and / or patient. In general, the shaft can extend, or be of such a length, for example, 5 cm to 40 cm, in particular 10 cm to 30 cm, preferably 15 cm to 25 cm along the main direction of extension. An outer diameter of the shaft can be, for example, 0.5 cm to 5 cm, in particular 0.5 cm to 3 cm, preferably 1 cm to 2 cm.

[0021] The channel can be understood as an entire imaginary, in particular cylindrical and preferably circular-cylindrical, space through which the plunger can be pushed. The channel can extend through the receiving space. In particular, the channel does not necessarily have to be delimited along its entire length by walls and / or the like. The channel can, for example, merge into the receiving space and / or extend through it without physical limitation. In particular, the channel can extend through the entire shaft up to the opening of the shaft. A diameter of the channel corresponds in particular to an inner diameter of the shaft. The agent can be conveyed through the channel. The channel can extend from the proximal end of the applicator to the distal end, in particular the opening. In this context, the channel can be longer than the shaft.The channel can, in particular, have a length of, for example, 5 cm to 60 cm, in particular 15 cm to 40 cm, preferably 20 cm to 30 cm. Furthermore, the channel can have an inner diameter of, for example, 0.1 cm to 4 cm, in particular 0.1 cm to 3 cm, preferably 1 cm to 2 cm. In principle, the inner diameter of the channel can be smaller than the outer diameter of the shaft.

[0022] In particular, the plunger can be provided for conveying the agent. The plunger can have an outer diameter that at least substantially corresponds to an inner diameter of the shaft and / or a diameter of the channel. Preferably, the plunger is designed to at least substantially precisely fit the shaft. This can mean that the plunger has an at least substantially slightly smaller outer diameter compared to the inner diameter of the shaft. The slightly smaller outer diameter can achieve pressure equalization during the conveyance of the agent along the channel. Furthermore, this can achieve comfortable mobility of the plunger because, for example, friction between the plunger and the shaft is low. The plunger can be guided to the channel at a proximal end of the applicator and can be pushed at least substantially to a distal end region of the shaft.During pushing, the plunger can pass through the receiving space and / or be pushed through it. The agent can be located in the receiving space. Because the plunger can be pushed through the receiving space, the agent can be fed from the receiving space, in particular along the channel, to the shaft by pushing the plunger. In principle, the plunger can have a length that corresponds at least substantially to the length of the channel. In some embodiments, in particular in embodiments with a curved shaft, the length of the plunger can be smaller than that of the channel such that, when the plunger is fully pushed in, a distal end of the plunger extends at least substantially into the vicinity of a beginning of a curved shaft section. In this case, the shaft can have the curved shaft section at its distal end.The advanced state can be defined by a stop of a part of the plunger at the proximal end of the applicator.

[0023] The actuating element can in particular be provided so that the receiving space can be reduced in size. Guided movement can in particular be understood to mean that the applicator comprises a guide device. In particular, the actuating element can be guided at least substantially over the entire range of movement by which it can be moved when the applicator is in the assembled state. In the assembled state, the actuating element is provided on the base body. For example, the actuating element can be plugged onto the base body. The actuating element can be in contact with the base body at least substantially continuously, in particular during the reduction in size. The actuating element can define the proximal end of the applicator. Furthermore, the actuating element can define the channel, in particular in a proximal section of the actuating element.The channel can generally extend through the actuating element, in particular through the proximal portion of the actuating element. The actuating element can have a further opening at its proximal end through which the plunger can be inserted into the applicator. The further opening can define the proximal end of the channel.

[0024] The receiving space can be provided so that the agent can be easily provided for application and / or introduced into the applicator. In particular, the receiving space can define a volume that is larger than the volume of the agent intended for application. The receiving space can extend at least substantially along the main direction of extent of the base body, in particular along the channel. Furthermore, the receiving space can be flat. This can mean that the receiving space comprises two directions of extent that are at least substantially perpendicular to one another and that at least substantially define the receiving space. In a third direction of extent that is perpendicular to these directions of extent, the receiving space can extend over a significantly shorter length. "Flat" should not be restricted to a flat design of the receiving space. The receiving space can be curved overall.The aforementioned directions of extension can therefore change depending on the location. In particular, the receiving space can have the shape of a hollow cylinder jacket section that extends only over part of a circumference of the hollow cylinder in question. Furthermore, the receiving space can at least substantially have a height that at least substantially corresponds to the inner diameter of the channel. The height can preferably mean the third direction of extension. The channel can extend along a side wall of the receiving space and / or be at least partially defined by the side wall of the receiving space. The part of the channel that can extend through the receiving space can also be open to the rest of the receiving space. As a result, the agent that is introduced into the receiving space can be fed to the channel. In particular, the agent can be fed to the channel by reducing the size of the receiving space.Reducing the size of the receiving space can be understood as allowing walls of the receiving space to move toward each other. In particular, the receiving space can be reduced in size in such a way that the applicator, in particular the base body and / or the actuating element, does not need to be elastically and / or plastically deformed.

[0025] The reduction in size is achieved by the relative movement between the base body and the actuating element. The relative movement can comprise a guided movement and / or a movement along a guide element of a guide device. In a reduced state of the receiving space, the application position can be defined. Furthermore, the relative movement can enable the actuating element to be moved relative to the base body in such a way that the channel extends through the applicator in such a way that the plunger can be pushed through the actuating element, the base body, the receiving space, and the shaft. In a position different from the application position, a channel section formed by the actuating element can be offset from the receiving space, the shaft, and / or a distal part of the channel.In particular, the plunger cannot be slidable in the different positions in such a way that the agent can be moved through the shaft and / or the agent can be applied. The application position can be defined by at least one mechanical stop. For example, the actuating element can be guided and movable relative to the base body up to the application position.

[0026] Furthermore, a portion of the agent located in the receiving space can also be located in the channel at the same time. The fact that the agent can be fed to the channel can mean that at least substantially a significant portion of the agent can be fed to the channel. For example, in a non-reduced state, the portion of the agent that is simultaneously in the receiving space and the channel may not be sufficient for an intended action. By feeding, the volume of the agent that can be transported with the plunger can be increased. Furthermore, the feeding can comprise compressing the agent. For example, by reducing the size of the receiving space and / or feeding, air can be removed from the receiving space. This can result in the agent being transported more continuously with the plunger. For example, the agent can be arranged more homogeneously in the channel than with conventional applicators.This can mean that, at least in essence, there are fewer air pockets in and / or between the medication, especially when the applicator is in the application position. The user feels a continuous force when moving the plunger and can dose the medication more effectively.

[0027] Furthermore, the receiving space can be reduced in size by the relative movement between the actuating element and the base body to a cross-section that at least substantially corresponds to the cross-section of the channel. It is understood that manufacturing tolerances and / or play can exist between the actuating element and the base body. In particular, the cross-section of the channel can be circular. The cross-section can at least substantially correspond to a cross-section of the plunger. Advantageously, starting from a state in which the receiving space is loaded with the agent, at least a large part of the agent can be fed to the channel. High efficiency with regard to material usage can be achieved. Furthermore, particularly in the region of the receiving space, the channel can be defined at least substantially continuously by walls.

[0028] In addition, the actuating element can be brought into a loading position by a relative movement to the base body, wherein the receiving space is accessible in the loading position. In particular, the actuating element can be brought into the loading position in a guided manner. This can mean that the actuating element can be brought selectively into the actuating element and / or the application position. The actuating element can, for example, be brought reversibly into the actuating element and / or the application position. Accessible can mean that the receiving space has an opening to an area surrounding the application instrument. For example, the user can load the application instrument in the loading position or introduce means into the receiving space. In particular, means can be introduced into the receiving space in the loading position.Additional positions, in particular relative positions between the actuating element and the base body, can also be provided in which the receiving space is accessible. The loading position can be the position in which loading can be carried out, at least essentially, most efficiently. The loading position can be defined by at least one mechanical stop. For example, two positions defined by mechanical stops can be provided. The positions can include the application position and the loading position. The application instrument can be operated in a particularly user-friendly and / or time-efficient manner by providing the loading position.

[0029] Furthermore, the actuating element can be insertable into the base body into an insertion position, wherein the insertion position corresponds at least substantially to the loading position. The insertion position can further comprise a starting position for the relative movement. The actuating element can, for example, be provided separately from the base body. Both parts can, for example, be available separately in sterile outer packaging. In a step in a chronological sequence shortly before the agent is introduced into the receiving space, it can be provided that the actuating element is inserted into the base body. The base body can, for example, comprise an insertion opening at its proximal end, which is designed such that the actuating element can be inserted at least partially into the base body. Advantageously, user-friendliness can be improved and the operability of the applicator can be simplified.

[0030] The guide device, in particular, can be of great importance for the insertion and / or relative movement. The guide device can, for example, be formed jointly by the actuating element and the base body. In some embodiments, the guide device can function similarly to a bayonet lock. In particular, the guide device can comprise a projection and / or a guide groove. When carrying out the relative movement, the projection can be guided in the guide groove. Alternatively or additionally, the guide device can comprise a section which is designed for inserting the actuating element into the base body. In the insertion position, the loading position and / or the application position, the actuating element can be at least partially received by the base body.

[0031] Furthermore, the base body can form a loading window through which the receiving space is accessible for loading with the agent, at least in a loading position of the actuating element. The loading window can, in particular, have dimensions that allow the agent to be introduced into the receiving space using a medical instrument. For example, the agent can be introduced using tweezers, a syringe, a hose, a pouring and / or pouring device, and / or the like. Furthermore, the window can be large enough for the practitioner to reach into the receiving space with their fingers. This makes it possible to provide a practical, compact, and / or user-friendly applicator.

[0032] Furthermore, the base body can be hollow-cylindrical in shape, at least in sections, and the loading window can be formed by a hole through a wall of the base body. Furthermore, a portion of the actuating element can be visible through the loading window. This can mean that the base body has a hollow space, into which the actuating element can be inserted. This allows for a cost-effective design and / or production of the applicator.

[0033] Furthermore, the receiving space can extend below the wall, at least in a loading position, so that the loading window covers a first section of the receiving space and the wall covers a second section of the receiving space. The base area of ​​the receiving space can be larger than a flat feature on the first wall defined by the loading window. Advantageously, this allows the material to be retained in the receiving space more efficiently and / or effectively after loading. The risk of the agent leaking out of the receiving space can be reduced.

[0034] According to the invention, the relative movement can comprise a rotation of the base body and the actuating element relative to one another. The rotation can occur relative to a longitudinal axis or central axis of the base body and / or the actuating element. In other words, the rotation can comprise a rotation of the actuating element about a longitudinal axis or central axis of the base body, or vice versa. The base body can circumferentially encompass the actuating element with respect to its longitudinal axis or central axis. Furthermore, the relative movement can comprise at least substantially exclusive rotation in one plane, wherein at least substantially no significant translational relative movement is provided between the actuating element and the base body. The rotation ensures simple operability. Furthermore, a compact design of the applicator can be achieved as a result. In other embodiments, the relative movement can comprise a translational movement.For example, the actuating element can be guided in a spiral relative to the base body. "Translative" can mean a direction that runs at least substantially parallel to the main extension direction.

[0035] In addition, the base body and the actuating element can form corresponding stop surfaces that define a maximum enlargement of the receiving space. The maximum enlargement of the receiving space can occur, in particular, in the loading position and / or the insertion position. The stop surfaces can be formed, for example, by the guide device. In other embodiments, the stop surfaces can extend, for example, along the cavity of the base body and / or extend in sections along an outer surface of the actuating element. Operating safety can be improved as a result. By predetermining defined positions, which are achieved through simple design measures, the applicator can be operated intuitively.

[0036] In addition, the actuating element can comprise a sliding section which defines a first side wall of the receiving space and which is designed to push the agent towards the channel during the relative movement and thereby compress it so that it can be conveyed by the plunger. An efficient applicator can be provided using a few parts. During the pushing process, air can also be removed from the receiving space. This can mean that the agent density in the receiving space and / or the channel can be increased. The sliding section can extend in particular from a lower part of the receiving space to the wall of the base body. The actuating element can be inserted into the base body in such a way that it can be provided with an at least substantially precise fit in the base body. This can mean that the sliding section can contact the wall of the base body.Furthermore, the sliding section can contact the wall of the base body at least substantially continuously during the closing process. This advantageously ensures that the agent can be delivered to the channel efficiently and / or effectively. The applicator is at least substantially less contaminated.

[0037] Furthermore, the base body can form a wall section that defines a second side wall of the receiving space. The side wall can be located opposite the sliding section. Additional side walls, which are at least substantially immovable toward one another, can extend laterally between the side wall and the sliding section. By reducing the size of the receiving space, the additional side walls can be made smaller. Advantageously, a cost-effective applicator can be provided. This requires few parts and has a simple construction.

[0038] Furthermore, the first side wall and the second side wall can jointly form a section of the channel in the application position. The first side wall and / or the second side wall can each be concave. In particular, the first side wall and / or the second side wall can have an at least substantially semicircular curvature and / or an at least substantially semicircular cross-section. The first side wall and the second side wall can jointly define a cylindrical channel in the application position. Furthermore, the first side wall and the second side wall can jointly define a circular opening to the cylindrical channel in the application position. The cylindrical channel can define the channel in sections.The side walls, which can define the relatively large receiving space in at least one relative position, can advantageously form the relatively small channel in another relative position. This allows for the realization of a particularly compact applicator, which can still be efficient to operate.

[0039] According to the invention, the actuating element can define a floor of the receiving space, at least in a loading position. The means can be introduced into the receiving space in such a way that it at least substantially covers the floor. For example, the applicator is intended to be held horizontally during loading. In a horizontal position, particularly when the receiving space is accessible from above, the floor represents the lower surface of the receiving space. The floor can have a larger area than the side surfaces, particularly in the loading position. Furthermore, the floor can have a larger surface area than the loading window. The floor is preferably curved overall. The floor can be significantly reduced in size by reducing the size of the receiving space. The floor can be defined in sections by the outer surface of the actuating element.In particular, the actuating element has a curved outer surface that forms the base. This curved outer surface can substantially correspond to a portion of a cylinder jacket. The outer surface can be movable relative to the second side surface of the receiving space. For example, the second side surface can be adjacent to the outer surface. The outer surface can be moved past the second side surface with at least substantially continuous contact. In particular, the part of the outer surface that defines the base can be moved past the second side surface. This can provide an efficient and / or compact applicator.

[0040] In addition, the actuating element can comprise a holding section that protrudes from the base body and is designed to be held by a user while performing the relative movement. This allows, for example, the parts of the applicator that are movably guided relative to one another to be gripped and / or mechanically fixed. This allows the applicator to be mechanically manipulated. The holding section can, for example, have a profiled, in particular grooved, surface. The holding section can also be referred to as an actuating section. This can improve the grip of the actuating element. In some embodiments, the actuating element has a distal section with a first diameter that can be inserted into the cavity of the base body, and a proximal section with a second

[0041] Diameter that is larger than the first diameter and / or than an inner diameter of the cavity. The second section can comprise and / or form the holding section. The actuating element can be mushroom-shaped overall. When inserted into the cavity, a widened portion of the actuating element, in particular of the holding section, can abut a proximal end of the base body, which forms an access opening to the cavity. The central axes of the base body and the actuating element can be arranged coaxially in the inserted state.

[0042] Furthermore, the base body and / or the actuating element can be formed in one piece. For example, the base body and / or the actuating element can be manufactured using a casting process, a milling process, and / or an additive manufacturing process. In particular, the base body and / or the actuating element can be a plastic part and / or can be formed from PVC (polyvinyl chloride), PET (polyethylene terephthalate), and PP (polypropylene). The applicator can be manufactured cost-effectively and / or efficiently.

[0043] In addition, the plunger can comprise a guide element designed to prevent rotation of the plunger during application and to guide the plunger along the channel. The plunger can comprise a delivery rod designed to be inserted into the channel. This can mean that the plunger can be partially inserted into the channel. The guide element can extend at least substantially parallel to the delivery rod. In particular, the guide element is rod-shaped and / or tubular. Furthermore, the delivery rod can be connected to the guide element at a proximal end of the plunger, for example via a base element, in particular a connecting plate. When the plunger, in particular the delivery rod, is fully inserted, the base element can bear against the actuating element. As a result, the delivery rod can always be reliably withdrawn from the channel.

[0044] In addition, the actuating element and / or the base body can form a guide channel and the guide element can be inserted into the guide channel. Furthermore, the guide element can be guided in the guide channel. In particular, the guide channel can be elongated. In addition, the guide channel can extend sectionally through the actuating element and the base body. Furthermore, the guide channel can extend through a center of rotation of the relative rotational movement between the actuating element and the base body. The guide channel is in particular arranged coaxially with the longitudinal axis or central axis of the base body and / or the actuating element. In particular, the guide channel can extend along an axis of rotation and / or a center of rotation of the actuating element and the base body. This makes it possible to provide a particularly reliable and compact applicator.The risk of incorrect operation and / or malfunction can be reduced.

[0045] In addition, the actuating element can be latched in the application position. In particular, the applicator can comprise a locking device designed to hold the actuating element in the application position relative to the base body. The locking device can be formed at least partially by the base body and / or the actuating element. Furthermore, the locking device can comprise a latching element and a latching section, wherein the latching element is designed to latch into the latching section. In particular, the latching element can be arranged on the base body and / or can be movable together with the base body. The latching section can be arranged on the actuating element. The latching element can, for example, comprise a spring-loaded latching ball and / or the latching section can comprise a spherical recess that at least substantially matches the latching ball.The locking element can be preloaded against an outer surface of the actuating element. In the application position, the actuating element can be locked in such a way that moving the actuating element from the application position requires such a high force that the locking element can be moved, in particular radially, out of the locking section. This makes it possible to increase the preload force of the locking element.

[0046] A method for loading a medical applicator according to the invention is also provided. The method comprises the steps of introducing an agent into the receiving space and moving the base body and the actuating element relative to one another to reduce the receiving space.

[0047] Furthermore, the method may comprise the step of inserting the actuating element into the base body.

[0048] The present invention is described below by way of example with reference to the accompanying figures. The drawings, the description, and the claims contain numerous features in combination. Those skilled in the art will expediently consider the features individually and use them in meaningful combination within the scope of the claims.

[0049] If there is more than one instance of a particular object, only one of them may be provided with a reference symbol in the figures and in the description. The description of this instance can be transferred accordingly to the other instances of the object. If objects are named using numerical terms, such as first, second, third object, etc., these serve to name and / or assign objects. Accordingly, for example, a first object and a third object, but not a second object, may be included. However, a number and / or sequence of objects could also be derived using numerical terms.

[0050] They show: Fig. 1 a schematic side view of a medical applicator without a plunger; Fig. 2 a schematic side view of the plunger; Fig. 3 a schematic side view of a base body; Fig. 4 a schematic view of the main body from the proximal side; Fig. 5 a schematic perspective view of the main body from the proximal side; Fig. 6 a schematic side view of an actuating element; Fig. Figure 7 is a schematic view of the actuator from the distal direction; Fig. Figure 8 is a schematic view of the actuator from the proximal direction; Fig. 9 a schematic side view of the applicator in an application position; Fig. 10 a schematic sectional view of the applicator in the application position from the proximal side; Fig. 11 a schematic side view of the applicator in a loading position; Fig. 12 a schematic sectional view of the applicator in the loading position from the proximal side; and Fig. 13 a schematic flow diagram of a method for loading the applicator.

[0051] In the Fig. 1 shows a schematic side view of a medical applicator 10 without a plunger 18. The plunger 18 associated with the medical applicator is shown in Fig. 2 in a schematic side view. Referring to both figures, the operation of the medical applicator 10 is described below.

[0052] The medical applicator 10 is intended for applying an agent. In the illustrated case, the agent is a cartilage-containing substance mixture, which is intended in particular for performing the "minced cartilage" procedure. The applicator 10 comprises a base body 12, a shaft 14, and an actuating element 20 and is illustrated in a state in which the actuating element 20 is arranged on or partially in the base body 12. The applicator 10 is fundamentally designed to be held by a user with one hand during application. The user's hand can, for example, at least partially grasp or enclose the base body 12. For ergonomic handling, the base body 12 has, for example, a circumferential recess 62 in a region close to its distal end 64. The recess 62 is designed as a circumferential taper, which makes handling the applicator 10 safer.

[0053] Particular attention should be paid to the Fig. 9 to 12. These illustrate that the actuating element 20 and the base body 12 can assume various relative positions to one another. The features described herein may depend, in particular, on the relative positions, as described in the context of the aforementioned figures.

[0054] The base body 12 and the actuating element 20 are made of a plastic and are formed in one piece. Furthermore, the base body 12 is partially hollow-cylindrical in shape. In particular, a proximal section 74 of the base body 12 is hollow-cylindrical in shape and defines a cavity 72. The cavity 72 or the proximal section 74 extends from a proximal end 76 of the base body 12 over 70% of the length of the base body 12. The cavity 72 is radially delimited by a wall 30. At the proximal end 76, the base body 12 has an opening 78 through which the actuating element 20 can be introduced at least partially and / or partially into the base body 12, in particular the cavity 72. The base body 12 is in the Fig. 3 to 5 in different views. Reference is made to these figures for some features. Furthermore, the base body 12 forms a loading window 26, which is formed by an opening 28 through the wall 30 of the base body 12. A receiving space 22 is accessible through the loading window 26. It is understood that this is particularly only for the Fig. 1 applies. The receiving space 22 is designed to receive the agent. As described in more detail in the following figures, the receiving space 22 is formed jointly by the base body 12 and the actuating element 20. In a sense, the receiving space 22 is created when the actuating element 20 is introduced into the cavity 72. The receiving space 22 is accessible for loading with the agent through the loading window 26. For this purpose, the loading window 26 has suitable dimensions. For example, the base body 12 shown is approximately as large as the hand of the practitioner. The base body 12 shown is, for example, 12 cm long in its main extension direction. The loading window is, for example, 4 cm long in the main extension direction and 2 cm wide. Any other dimensions are conceivable and can depend in particular on the agent to be used.

[0055] Furthermore, it can be seen that the receiving space 22 extends below the wall 30. In sections, the wall 30 can delimit the receiving space 22 in the radial direction. The loading window 26 covers a first section 32 of the receiving space 22 and the wall 30 a second section 34 of the receiving space 22. At the proximal end 76, the receiving space 22, as shown in the Fig. 1, is limited in sections by the actuating element 20 and at the distal end 64 by the base body 12. The base body 12 comprises a projection 81 which is inserted into the Fig. 4 and Fig. 5. Radially inward, the receiving space 22 is defined by a base 48, which is defined by the actuating element 20.

[0056] The actuating element 20 partially protrudes beyond the proximal end of the base body 12. In particular, a holding section 50 of the actuating element 20 protrudes from the base body in the proximal direction. The holding section 50 is designed to be held by the user when performing the relative movement. For this purpose, the holding section 50 is profiled. The holding section 50 has recesses at periodic intervals that improve the grip of the holding section 50. Furthermore, the holding section 50 has a larger diameter than the cavity 72 of the base body 12. When the actuating element 20 is inserted into the cavity 72, the holding section 50 thus at least partially protrudes beyond the base body. This means that the holding section 50 defines a mechanical stop that contacts the base body 12 in the inserted state.The holding section 50 can in particular cooperate with a guide device 80 which is connected to the . Fig. 5 and Fig. 6 is described.

[0057] In addition, the applicator 10 comprises a locking device 60, which is designed to hold the actuating element relative to the base body 12 in an application position. The locking device 60 is partially formed by the base body 12 and the actuating element 20. The locking device 60 comprises a latching element (not shown in detail) and a latching section (not shown in detail), wherein the latching element is designed to latch into the latching section. The latching element is arranged on the base body 12. In the Fig. 5 shows a mounting hole provided for mounting the locking element. The locking section is arranged on the actuating element 20. The locking element comprises a spring-loaded locking ball, and the locking section comprises a spherical recess that at least substantially matches the locking ball. The locking element is preloaded radially inward against an outer surface of the actuating element 20.

[0058] At the distal end 64, the base body 12 includes a shaft mounting recess 82 ( Fig. 9) which extends along the main extension direction of the base body 12. The shaft 14 is arranged in the shaft mounting recess 82. The shaft 14 is rod-shaped and hollow-cylindrical and comprises a section of a channel which is in the Fig. 1 is not shown in detail. The part of the shaft 14 that projects beyond the base body 12 is approximately as long as the base body 12. At its distal region 56, the shaft 14 has a bend. In addition, the shaft 14 has an opening 58 at the distal end, which represents a distal end of the channel. The channel is designed so that the agent can be conveyed through the channel and fed to an application site. For example, the application site can be defective cartilage. The distal end, in particular the opening 58, can be brought into the vicinity of the defect and the agent can be fed to the defect. This can mean that the agent is applied to the defect. The channel extends at least through the shaft 14 and the base body 12, as can be seen in more detail in the following figures. The shaft 14 is bent such that the agent can be applied at an angle of 20° relative to a longitudinal axis of the shaft 14.

[0059] In the application position, the channel extends through the shaft 14, the base body 12 and the actuating element 20. These components have, at least in sections, bores, holes, passages and / or the like, which are arranged concentrically to one another in the application position. Furthermore, in the application position, the plunger 18 ( Fig. 2) are inserted into the channel to apply the agent. The plunger 18 comprises a delivery rod 66, which can be inserted into the channel, a guide element 52, a handling section 70, and a base element 68. The delivery rod 66, the handling section 70, and the guide element 52 are connected to one another via the base element 68. In particular, the base element 68 can provide the plunger 18 with the necessary mechanical stability. The user can operate the plunger 18 by means of the handling section 70. In particular, when the delivery rod 66 is inserted into the channel, the user can use the handling section 70 to convey the agent to the opening 58. For this purpose, the handling section 70 has a half-open clamp 71, which the user can grip for handling. For transport, the user pushes the plunger 18 from the proximal side towards the distal end of the applicator 10.The guide element 52 can be inserted into a guide channel and is designed to prevent rotation of the plunger 18 during application and to guide the plunger 18, in particular the delivery rod 66, along the channel. If the guide element 52 were not provided, for example, a moment caused by the user during application by operating the handling section 70 could cause the plunger 18 to rotate around the delivery rod 66. This is at least substantially prevented by the guide element 52. The guide channel associated with the guide element 52 is shown in more detail in the following figures. The guide element 52 has a slightly larger diameter than the delivery rod 66 and is shorter. In particular, the guide element 52 is approximately as long as the object formed jointly by the holding section 50 and the base body 12 in the inserted state of the actuating element 20.When the plunger 18 is fully inserted into the channel, the base element 68 abuts the distal end of the actuating element 20. This prevents further advancement of the conveyor rod 66.

[0060] In the Fig. 3, Fig. 4 and Fig. 5, some features of the base body 12, which have already been described in connection with the previous figures, can be seen more clearly. Fig. 3 shows a schematic side view of the base body 12, the Fig. 4 shows a schematic view of the base body 12 from the proximal side 76 and the Fig. 5 shows a schematic perspective view of the base body 12 from the proximal side 76. In the Fig. 4 and Fig. 5, one can particularly see into the hollow cylindrical base body 12. In particular, features can be seen that define the receiving space 22. Basically, it can be seen that the base body 12 is open at its proximal end and defines a proximal opening. The actuating element 20 can be inserted through the proximal opening. The wall 30 of the base body 12 can be seen. The loading window 26 is formed as an opening 28 through the wall 30. Furthermore, the base body 12 forms the projection 81, which defines a distal side wall of the receiving space 22, particularly in a position different from the application position. The projection 81 defines a circumferential surface that is arranged at least substantially perpendicular to the main extension direction of the base body 12. The channel 16 runs in the main extension direction and is arranged at least substantially perpendicular to the projection 81.The base body 12 forms the channel 16 in sections. A hole 87 is arranged in the projection 81, which runs along the channel 16 and forms the channel 16 in sections. The hole 87 can be formed together with the shaft mounting recess 82 and / or extend as far as the shaft 14 when the shaft 14 is arranged in the base body 12. Furthermore, the hole 87 is arranged concentrically with the shaft 14 and / or the shaft mounting recess 82. Starting from the hole 87, a wall section 42 extends towards the proximal end of the base body 12 and defines a second side wall of the receiving space 22. The wall section 42 forms a section 46 of the channel 16 in the application position. The section 46 extends along the wall section 42. The wall section 42 is convex on the channel side and at least substantially semicircular.A radius of the curvature defining the channel-side portion corresponds at least substantially to a radius of the hole 87 and the channel 16. The wall portion 42 is arranged on a projection 43 which projects from the wall 30 into the cavity 72.

[0061] At the proximal end, the wall section 42 borders on a part of the guide device 80. In particular, the wall section 42 borders on a guide groove 84 of the guide device 80. The guide groove 84 extends circumferentially on an inner surface of the wall 30 over approximately 25% of the entire circumference. Furthermore, the guide groove 84 runs along an imaginary circle that is arranged at least substantially perpendicular to the channel 16. At one end of the guide groove 84, the guide device 80 has an insertion groove 86 that extends at least substantially perpendicular to the guide groove 84 as far as the proximal end of the wall 30. The insertion groove 86 expands a radius of the proximal opening 73 in some regions. Two of the insertion grooves 86 and guide grooves 84, which are of identical design, are arranged opposite one another on the circumferential side.

[0062] The guide device 80, in particular the insertion groove 86, is configured to allow the actuating element 20 to be inserted into the base body 12 into an insertion position that defines a relative position of the actuating element 20 to the base body 12. In the insertion position, the receiving space 22 has a maximum enlargement. At the same time, the insertion position defines a loading position in which the receiving space 22 is accessible through the loading window 26 for loading with the agent. The application position is defined by the second end of the guide groove 84. The guide groove 84 is configured to guide the actuating element 20 during a movement. The movement is, in particular, a rotation of the actuating element 20. The actuating element can be rotated from a loading position, in particular the insertion position, to the application position. The guide device 80 is also partially formed by the actuating element 20.On the actuating element 20, as shown in the . Fig. 6 and Fig. As can be seen in Figure 7, guide elements 85, in particular guide lugs and / or guide groove springs, are formed. The guide elements 85, together with the insertion grooves 86, define the relative rotational position between the base body 12 and the actuating element 20, in which the actuating element 20 can be inserted into the cavity 72. Furthermore, the guide elements 85 and the guide grooves 84 define an axial advance position of the actuating element 20 in the cavity 72. Furthermore, the guide grooves 84, together with the guide elements 85, guide the actuating element 20.

[0063] The position with the maximum enlargement of the receiving space 22, in particular the insertion position, is also defined by corresponding stop surfaces 36. One of the stop surfaces 36 is arranged on a projection formed by the base body 12 and protruding into the cavity 72.

[0064] Furthermore, a part of the guide channel 54 is arranged in the center of the base body 12 (see Fig. 4).

[0065] In the Fig. 6, Fig. 7 and Fig. 8 shows the actuating element 20 in different views. Fig. 6 shows a schematic side view of the actuating element 20, the Fig. Figure 7 shows a schematic view of the actuating element 20 from the distal direction and the Fig. Figure 8 shows a schematic view of the actuating element 20 from the proximal direction.

[0066] The actuating element 20 comprises the holding portion 50, the base portion 90, the space portion 89, and the locking portion 91. In some embodiments, the actuating element 20 may be mushroom-shaped overall. The holding portion 50 is already described in connection with the Fig. 1. Additionally, a hole 88 is formed in the handle portion, which, in the application position, is arranged concentrically with the channel 16. The delivery rod 66 can be inserted into the channel 16 through the hole 88. Furthermore, the hole 88 has at least substantially the same diameter as the hole 87.

[0067] The base section 90 distally adjoins the holding section 50. In the state in which the actuating element 20 is inserted into the cavity 72, the base section 90 is at least substantially flush with the proximal end of the main body 12. The base section 90 defines the proximal end of the receiving space 22 and comprises the guide elements 85. The guide elements 85 protrude circumferentially from the base section 90. The base section is at least substantially circular and is designed to fit precisely into the cavity 72. This ensures that the receiving space 22 is sealed. The base section 90 is also perforated by a continuation of the hole 88. The hole 88 extends through the base section 90 and the holding section 50. A distal surface of the base section 90 is at least substantially flush with the proximal end of the projection 43 in the inserted state.The hole 88 is continued in the application position by the wall section 42 and a sliding section 38. The sliding section 38 is separated from the actuating element 20 along the.

[0068] Space section 89 is formed. Furthermore, the sliding section 38 defines a first side wall of the receiving space 22. The sliding section 38 is designed similarly to the wall section 42. Together, the sliding section 38 and the wall section 42 form the channel 16 in sections in the application position and together define a hole with at least substantially the same diameter as the hole 87 and the hole 88. The sliding section 38 is designed in particular to push the agent towards the channel 16 during the relative movement. The channel 16 extends along the wall section 42 and is partially formed by the wall section 42. By pushing the agent closed, it is compressed in such a way that it can be conveyed by the plunger 18, in particular the conveying rod 66.

[0069] Furthermore, the space section 89 forms one of the corresponding stop surfaces 36, which can interact with the corresponding stop surface 36 of the base body 12.

[0070] The locking section 91 adjoins distally. The actuating element 20 partially forms the locking device 60 in the locking section 91. In particular, the actuating element 20 forms a latching section, preferably a spherical recess. A further part of the locking device 60 can be formed and / or received by the base body 12. The base body has, see Fig. 5, a bore in which, for example, a spring-loaded ball is arranged. The ball is pressed radially inward against the locking portion 91 of the actuating element 20 by a preload. In the application position, the ball is pressed into the spherical recess of the actuating element 20. In the application position, the actuating element 20 can thus be locked.

[0071] The room section 89 is divided into sections, as in the Fig. 7, is tapered and has a smaller radius than the base section 90. This defines the bottom 48 and provides a recess for the receiving space 22. In a loading position, the receiving space 22 is partially defined radially outwardly by the loading window 26 and the wall 30, and radially inwardly by the actuating element 20, in particular the bottom 48.

[0072] Furthermore, the actuating element 20 forms in its center ( Fig. 7 and Fig. 8) sections the guide channel 54. The guide element 52 can be inserted into the guide channel 54 through the proximal end of the actuating element 20. The actuating element-side section of the guide channel 54 is arranged concentrically with the base body-side section of the guide channel 54. Furthermore, both sections have at least substantially the same diameter.

[0073] In the Fig. 9 to 12, the applicator 10 is in the application position ( Fig. 9 and Fig. 10) and in a loading position ( Fig. 11 and Fig. 12), in particular the position with maximum magnification of the recording space 22. The Fig. Figure 9 shows a schematic side view of the applicator 10 in the application position, the Fig. Figure 10 shows a schematic sectional view of the applicator 10 in the application position from the proximal side, the Fig. 11 shows a schematic side view of the applicator 10 in a loading position and the Fig. Figure 12 shows a schematic sectional view of the applicator 10 in the loading position from the proximal side. Fig. 9 and Fig. 11 shows which section plane is shown in the corresponding section views.

[0074] In the application position, the channel 16 extends through the shaft 14, through the base body 12 and the actuating element 20. The hole 88 of the actuating element 20 is arranged concentrically with the channel 16. The actuating element 20, in particular the hole 88, can be moved from this position by rotating the actuating element 20 and in particular can be brought into a loading position. In the loading position (see Fig. 11 and Fig. 12), the receiving chamber 22 is accessible through the loading window 26 and can be loaded with the agent, but the hole 88 is not arranged concentrically to the channel. In this position, the plunger 18 cannot be inserted into the channel 16 and the agent cannot be conveyed by means of the plunger 18. In the application position ( Fig. 10) the receiving space 22 is reduced in size and is not accessible through the loading window 26.

[0075] You can see in the Fig. 10, that the first side wall 40, in particular the sliding section 38, and the second side wall 44, in particular the wall section 42, together form a section 46 of the channel 16 in the application position. From one of the loading positions, the receiving space 22 has been reduced in size by the user rotating the actuating element 20 in a guided manner such that its cross section 24 at least substantially corresponds to the cross section of the channel 16. Furthermore, by rotating the means which is

[0076] The medium is compressed and / or fed into the channel 16 after it has been received in the receiving space 22. This allows the medium to be conveyed particularly efficiently through the plunger 18. Furthermore, two corresponding walls 100 of the base body 12 and the actuating element 20 abut one another. Furthermore, the actuating element 20 is locked in the application position.

[0077] In the Fig. 12, the applicator 10 is also shown in the insertion position. In the position shown, the corresponding stop surfaces 36 are in contact, thereby defining a maximum enlargement of the receiving space. In this position, the user can introduce agent into the receiving space 22. The user can then feed the agent into the channel 16 by rotating it. It can be seen that the receiving space 22 is defined by the sliding section 38, the wall section 42, the base 48, the wall 30, and the loading window 26. By rotating it, the section in the base area and the wall and loading window area that defines the receiving space is reduced. In the application position, the receiving space is defined at least substantially only by the wall section 42 and the sliding section 38. The size, in particular the volume, of the receiving space 22 can therefore be changed by rotating it.Furthermore, it can be seen that the actuating element 20 is at least substantially fitted into the cavity 72 of the base body with such a precise fit that the tightness required for operation is achieved.

[0078] The Fig. 13 shows a schematic flow diagram of a method for loading the applicator 10. For a detailed description, reference is made to the description in connection with the preceding figures. The method described below can be carried out in any reasonable order and / or individual steps can be omitted. The method comprises a step 92 of introducing an agent into the receiving space 22, a step 94 of moving the base body 12 and the actuating element 20 relative to one another to reduce the receiving space 22, and a step 96 of inserting the actuating element 20 into the base body 12. List of reference symbols 10 Medical applicator; 12 basic bodies; 14 shaft; 16 channel; 18 pestles; 20 Actuating element; 22 recording room; 24 cross section; 26 loading windows; 28 breakthrough; 30 wall; 32 first section; 34 second section; 36 stop surfaces; 38 sliding section; 40 first side wall; 42 wall section; 43 lead; 44 second side wall; Section 46; 48 floor; 50 stopping section; 52 guide element; 54 guide channel; 56 distal end region; 58 opening; 60 locking device; 62 recess; 64 distal end; 66 conveyor rod; 68 base element; 70 Handling section; 72 cavity; 73 proximal opening; 74 proximal section; 76 proximal end; 78 opening; 80 guide device; 81 lead; 82 Shaft mounting recess; 84 guide groove; 85 guide element; 86 insertion groove; 87 holes; 88 holes; 89 room section; 90 base section; 91 locking section; 92 steps; 94 steps; 96 steps; and 100 corresponding walls.

Claims

[1] Medical applicator (10) for applying an agent, comprising: a base body (12); a shaft (14) arranged on the base body (12), wherein the base body (12) and the shaft (14) form a channel (16) which extends through the base body (12) and the shaft (14) and through which the agent can be supplied to an application site; a plunger (18) which can be inserted into the channel (16) in order to apply the agent, an actuating element (20) which is movable and guided on the base body (12); and a receiving space (22) formed by the base body (12) and / or the actuating element (20) and adapted to receive the means; wherein the actuating element (20) can be brought into an application position by a relative movement to the base body (12), wherein the receiving space (22) can be reduced in size by the relative movement between the actuating element (20) and the base body (12), wherein agent introduced into the receiving space (22) can be fed to the channel (16) by reducing the size of the receiving space (22), and wherein the relative movement comprises rotating the base body (12) and the actuating element (20) relative to one another. [2] Medical applicator (10) for applying an agent, comprising: a base body (12); a shaft (14) arranged on the base body (12), wherein the base body (12) and the shaft (14) form a channel (16) which extends through the base body (12) and the shaft (14) and through which the agent can be supplied to an application site; a plunger (18) which can be inserted into the channel (16) in order to apply the agent, an actuating element (20) which is movable and guided on the base body (12); and a receiving space (22) formed by the base body (12) and / or the actuating element (20) and adapted to receive the means; wherein the actuating element (20) can be brought into an application position by a relative movement to the base body (12), wherein the receiving space (22) can be reduced in size by the relative movement between the actuating element (20) and the base body (12), wherein agent introduced into the receiving space (22) can be fed to the channel (16) by reducing the size of the receiving space (22), and wherein the actuating element (20) defines a base (48) of the receiving space (22) at least in a loading position. [3] Medical applicator (10) according to claim 1 or 2, wherein the receiving space (22) can be reduced by the relative movement between the actuating element (20) and the base body (12) to a cross section (24) which corresponds at least substantially to the cross section of the channel (16). [4] Medical applicator (10) according to one of the preceding claims, wherein the actuating element (20) can be brought into a loading position by a relative movement to the base body (12), wherein the receiving space (22) is accessible in the loading position. [5] Medical applicator according to claim 4, wherein the actuating element (20) can be inserted into an insertion position in the base body (12), wherein the insertion position corresponds at least substantially to the loading position. [6] Medical applicator (10) according to one of the preceding claims, wherein the base body (12) forms a loading window (26) through which the receiving space (22) is accessible for loading with the agent at least in a loading position of the actuating element (20). [7] Medical applicator (10) according to claim 6, wherein the base body (12) is at least partially hollow-cylindrical, and wherein the loading window (26) is formed by an opening (28) through a wall (30) of the base body (12). [8] Medical applicator (10) at least according to claim 6 and 7, wherein the receiving space (22) extends below the wall (30) at least in a loading position, so that the loading window (26) covers a first portion (32) of the receiving space (22) and the wall (30) covers a second portion (34) of the receiving space (22). [9] Medical applicator (10) according to one of the preceding claims, wherein the base body (12) and the actuating element (20) form corresponding stop surfaces (36) which define a maximum enlargement of the receiving space (22). [10] Medical applicator (10) according to one of the preceding claims, wherein the actuating element (20) comprises a sliding portion (38) which defines a first side wall (40) of the receiving space (22) and which is adapted to push the agent towards the channel (16) during the relative movement and thereby compress it so that it can be conveyed by the plunger (18). [11] Medical applicator (10) according to one of the preceding claims, wherein the base body (12) forms a wall portion (42) which defines a second side wall (44) of the receiving space (22). [12] Medical applicator (10) at least according to claim 10 and 11, wherein the first side wall (40) and the second side wall (44) together form a portion (46) of the channel (16) in the application position. [13] Medical applicator (10) according to one of the preceding claims, wherein the actuating element (20) comprises a holding portion (50) which protrudes from the base body (12) and which is adapted to be held by a user while performing the relative movement. [14] Medical applicator (10) according to one of the preceding claims, wherein the base body (12) is formed in one piece and / or wherein the actuating element (20) is formed in one piece. [15] Medical applicator (10) according to one of the preceding claims, wherein the plunger (18) comprises a guide element (52) which is adapted to prevent rotation of the plunger (18) during application and to guide the plunger (18) along the channel (16). [16] Medical applicator (10) according to claim 15, wherein the actuating element (20) and / or the base body (12) forms a guide channel (54), and wherein the guide element (52) can be introduced into the guide channel (54). [17] Medical applicator (10) according to one of the preceding claims, wherein the actuating element (20) can be locked in the application position. [18] Method for loading a medical applicator (10) according to one of the preceding claims, comprising the steps: Introducing an agent into the receiving space (22), and Moving the base body (12) and the actuating element (20) relative to each other in order to reduce the receiving space (22). [19] A method for loading a medical applicator (10) according to claim 18, further comprising the step: Inserting the actuating element (20) into the base body (12).

Images