Endoscopic Powder: A Game-Changer in Haemostasis for Minimally Invasive Surgery
The ability to achieve reliable haemostasis is vital in every surgical setting. It not only limits blood loss during surgery but also lowers risks of transfusion and complications after the procedure. In minimally invasive surgeries like laparoscopy or endoscopy, controlling bleeding is especially challenging due to limited space, visibility, and anatomical intricacy.
As more procedures move toward minimally invasive methods, there’s a greater demand for flexible, effective bleeding control solutions when traditional methods aren’t enough.
The Haemostatic Challenge in MIS
Minimally invasive surgery provides advantages including faster healing and minimal scarring, but also presents new obstacles for bleeding control. However, these benefits come with the challenge of difficult bleeding management. Limited maneuverability, constrained visualization, and the absence of tactile feedback make it harder to manage diffuse or irregular bleeding.
Suturing, tying, or cauterising are not always feasible in minimally invasive procedures. This is where topical haemostatic products—particularly endoscopic powders—are essential for boosting visibility and rapid bleeding control.
Understanding Surgi-ORC® Endoscopic Powder
One of the most promising powdered forms—a plant-based, absorbable haemostat with a proven safety and efficacy profile. Originally launched as a sheet in 1943, ORC has now been adapted into powder to address the needs of current minimally invasive surgeries.
Advantages of Surgi-ORC® Endoscopic Powder
• Accelerated Clotting: ORC’s mechanism enhances platelet activity and clot formation
• Adaptable Coverage: Powdered ORC easily conforms to irregular or deep wound areas
• Plant-Derived and Safe: No animal or human materials, so lower immune or infection risk
• Bactericidal Properties: Acidic environment inhibits bacterial growth
• Biodegradable and Safe: Powder is absorbed with no toxicity, even near sensitive structures
With these properties, Surgi-ORC® endoscopic powder is perfect for mild-to-moderate bleeding, particularly from capillaries, veins, or small arteries in hard-to-reach areas.
Delivery Devices: Enhancing Precision in MIS
How the powder is delivered greatly influences its effectiveness in surgery. In MIS, bellows pump-based applicators are widely used to deliver endoscopic powder with accuracy and control.
Operation of Endoscopic Powder Applicators
These applicators—resembling syringe-like devices—are equipped with short or long applicator tips designed to deliver the powder through laparoscopic ports or trocars. The bellows mechanism lets surgeons deposit powder accurately without blocking the field of view.
Maximizing Effectiveness: Usage Tips
• Device Orientation: The angle of application (vertical/horizontal) affects how the powder spreads—often more than compression speed
• Powder Properties: The grain size and flowability, plus moisture sensitivity, impact delivery
• Application Style: The surgeon’s technique and compression force also influence powder delivery
Where Endoscopic Powder Excels in Practice
In cases where visibility is poor or anatomy is complex, endoscopic powder becomes an essential tool. Its flexible form lets it cover both wide wounds and tight spaces with equal efficiency.
Endoscopic Powder is Commonly Used For:
• Liver resections performed laparoscopically
• Cardiothoracic
• Gynaecologic laparoscopic procedures
• Submucosal dissection cases
• Minimally invasive urology surgeries
Using endoscopic powder helps surgeons see better, stop bleeding quicker, and complete operations faster—often with less need for transfusions and better patient outcomes.
Clinical Evidence: Proven Performance of ORC Powder
Research on SURGICEL® Powder in 103 surgical patients found:
• Hemostasis was achieved in 87.4% of cases at 5 minutes, and 92.2% at 10 minutes
• Excellent results across open and minimally invasive surgeries
• No complications such as rebleeding, thromboembolism, or side effects reported
• Surgeons found it easy to use, highly effective, and praised the precise delivery with little extra intervention needed
These findings confirm that SURGICEL® Powder is safe, efficient, and versatile, particularly for managing mild-to-moderate bleeding where traditional methods may fall short.
Conclusion
With minimally invasive surgery on the rise, there’s a growing need for innovative bleeding control solutions. Endoscopic powder, particularly ORC-based formulations, stands out as a reliable, fast-acting, and surgeon-friendly solution for bleeding control.
No matter the complexity—be it confined spaces, delicate organs, or irregular wounds—ORC endoscopic powder ensures safe, effective bleeding control for today’s surgical demands.
References
1. Zhang Y, Song D, Huang H, Liang Z, Liu H, Huang Y, Zhong C, Ye G. Minimally invasive hemostatic Endoscopic Powder materials: tackling a dilemma of fluidity and adhesion by photopolymerization in situ. Scientific Reports. 2017 Nov 10;7(1):15250.
2. De la Torre RA, Bachman SL, Wheeler AA, Bartow KN, Scott JS. Hemostasis and hemostatic agents in minimally invasive surgery. Surgery. 2007 Oct 1;142(4):S39-45.
3. Al-Attar N, de Jonge E, Kocharian R, Ilie B, Barnett E, Berrevoet F. Safety and hemostatic effectiveness of SURGICEL® powder in mild and moderate intraoperative bleeding. Clinical and Applied Thrombosis/Hemostasis. 2023 Jul;29:10760296231190376.
4. Xiao X, Wu Z. A narrative review of different hemostatic materials in emergency treatment of trauma. Emerg Med Int. 2022;2022: 6023261
5. Stark M, Wang AY, Corrigan B, Woldu HG, Azizighannad S, Cipolla G, Kocharian R, De Leon H. Comparative analyses of the hemostatic efficacy and surgical device performance of powdered oxidized regenerated cellulose and starch-based powder formulations. Research and Practice in Thrombosis and Haemostasis. 2025 Jan 1;9(1):102668.
6. Bustamante-Balén M, Plumé G. Role of hemostatic powders in the endoscopic management of gastrointestinal bleeding. World Journal of Gastrointestinal Pathophysiology. 2014 Aug 15;5(3):284.