A medical device (1), comprising a sheath element (11) suitable for contact, during a surgical operation, with a living hard tissue and / or with a hard tissue replacement material, in which the element of sheath has a longitudinal hole defining a longitudinal opening (13) extending from a proximal end of the sheath element to a distal direction, and a plurality of holes (14) in a wall of the opening, in which the device The doctor also comprises a liquefiable element (21) that is insertable or is inserted into the longitudinal opening (13) and at least partially liquefiable by the impact of incident energy from the proximal side so that the liquefied material flows through the holes ( 14) in the wall and outside the longitudinal opening inside the structures of the hard tissue and / or the hard tissue replacement material, in which the medical device is characterized by a structure (11 .2, 12, 1.5) guideline having a structure that varies as a function of the azimuthal angle with respect to a longitudinal axis (3) of the longitudinal opening to direct different parts of the liquefiable material to different holes between the holes.Un dispositivo (1) médico, que comprende un elemento (11) de vaina adecuado para ser puesto en contacto, durante una operación quirúrgica, con un tejido duro vivo y/o con un material de sustitución de tejido duro, en el que el elemento de vaina tiene un agujero longitudinal que define una abertura (13) longitudinal que se extiende desde un extremo proximal del elemento de vaina a una dirección distal, y una pluralidad de orificios (14) en una pared de la abertura, en el que el dispositivo médico comprende además un elemento (21) licuable que es insertable o es insertado en la abertura (13) longitudinal y al menos parcialmente licuable por el impacto de energía incidente desde el lado proximal de manera que el material licuado fluye a través de los orificios (14) en la pared y fuera de la abertura longitudinal al interior de las estructura
