Endoscopic Powder: A Game-Changer in Haemostasis for Minimally Invasive Surgery

The ability to achieve reliable haemostasis is vital in every surgical setting. Besides reducing bleeding, proper haemostasis cuts down the chances of transfusions and post-surgical issues. 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.

 

 

Challenges of Haemostasis in Minimally Invasive Surgery

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. Reduced access, poor visualisation, and no sense of touch make handling bleeding in MIS more difficult.

Conventional techniques like suturing, tying off vessels, or cauterization can be difficult to use during MIS. That’s where topical haemostatic agents, especially endoscopic powder, come into play as vital adjuncts to improve visibility, control oozing, and speed up procedures.

 

 

Spotlight on Surgi-ORC®-Based Endoscopic Powder

Surgi-ORC® endoscopic powder is a standout, plant-derived, absorbable haemostat with robust clinical backing. ORC was first introduced in 1943 in sheet form and has since evolved to meet the demands of modern MIS through powder formulations.

 

 

Why Surgi-ORC®-Based Endoscopic Powder Stands Out

• Effective Haemostasis: ORC facilitates platelet adhesion and aggregation to accelerate clotting
• Shape Plasticity: The granular structure of powdered haemostats and their shape plasticity allows them to conform easily to large and deep surface wounds
• No Animal Content: Plant origin means reduced risk of allergic or infectious complications
• Antibacterial Environment: The oxidation process lowers pH, creating an acidic microenvironment that offers bactericidal benefits
• Biocompatible and Absorbable: Completely resorbed by the body with no cytotoxic effects, even near nerves or vessels

These characteristics make Surgi-ORC® endoscopic powder an ideal choice for managing mild to moderate bleeding—especially capillary, venous, or small arterial oozing in confined spaces.

 

 

Optimizing Application with Delivery Devices 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.

 

 

Key Considerations for Optimal Use

• Orientation: How you hold the device (vertically or horizontally) influences powder distribution more than how hard you squeeze
• Powder Properties: The grain size and flowability, plus moisture sensitivity, impact delivery
• Operator Technique: Delivery efficiency varies based on how quickly and forcefully the bellows are compressed [5]

 

 

Real-World Applications of Endoscopic Powder

When working in tight spaces or near fragile tissues, endoscopic powder is especially useful. Because of its conformability, surgeons can treat both broad raw surfaces and deep crevices with ease.

Common Endoscopic Powder Uses Include:

• Laparoscopic liver resections
• Thoracic surgery procedures
• Laparoscopic gynaecologic interventions
• Endoscopic procedures like ESD
• Urological surgeries

By enhancing visibility and enabling faster bleeding control, endoscopic haemostats can shorten operative time, reduce the need for blood products, and contribute to better surgical outcomes [6].

 

 

ORC Powder: Efficacy and Safety in Studies

A postmarket clinical study evaluating SURGICEL® Powder (ORC-based haemostatic agent) in 103 patients undergoing various surgical procedures reported:

• 87.4% of patients had bleeding stopped in 5 minutes; 92.2% within 10 minutes
• Effective in both open and MIS procedures
• No complications linked to the product: no rebleeding, clots, or negative reactions
• Surgeons noted its ease of use, accuracy, and minimal need for extra measures

This evidence supports the safety, efficiency, and flexibility of SURGICEL® Powder for difficult bleeding scenarios.

 

 

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 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.