Endoscopic Powder: A Game-Changer in Haemostasis for Minimally Invasive Surgery
Effective control of haemostasis is critical to the success of any surgical procedure. 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. Limited maneuverability, constrained visualization, and the absence of tactile feedback make it harder to manage diffuse or irregular bleeding.
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.
Understanding Surgi-ORC® 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.
Advantages of Surgi-ORC® Endoscopic Powder
• Accelerated Clotting: ORC’s mechanism enhances platelet activity and clot formation
• Conformability: The powder’s granular shape adapts to wounds, covering both large and deep surfaces
• Plant-Derived and Safe: No animal or human materials, so lower immune or infection risk
• Antibacterial Action: Acidic pH helps kill bacteria at the wound site
• Fully Absorbable: Powder dissolves safely, posing no harm to nerves or vessels
Thanks to these features, Surgi-ORC® powder excels at controlling bleeding from small vessels in restricted surgical fields.
Precision Application: Endoscopic Powder Delivery Devices
The delivery method is a critical yet often overlooked factor in a powder’s haemostatic performance. Most MIS procedures rely on bellows-type applicators for controlled and accurate powder delivery.
Operation of Endoscopic Powder Applicators
Syringe-style bellows devices, fitted with short or long tips, can deliver powder through MIS access points. Compressing the bellows dispenses a controlled amount of powder right onto the bleed, maintaining clear visibility.
Best Practices for Using Endoscopic Powder
• Orientation: The angle of device orientation (vertical vs. horizontal) has a significant impact on the amount and spread of the powder. Surprisingly, orientation often affects performance more than the speed or force of compression
• Powder Characteristics: Particle size, flow, and how the powder handles moisture will affect performance
• Surgeon Technique: Output depends on the speed and force used when compressing the bellows
Clinical Uses 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.
Endoscopic Powder is Commonly Used For:
• Laparoscopic liver resections
• Cardiothoracic
• Gynaecology MIS surgeries
• 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
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
• Strong performance in open and minimally invasive settings
• No complications linked to the product: no rebleeding, clots, or negative reactions
• Surgeons rated it highly effective and easy to use, with precise powder delivery and minimal need for additional intervention [3]
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. Among these, ORC endoscopic powder has proven to be both efficient and easy for surgeons to use.
From deep pelvic cavities to exposed liver surfaces or tight endoscopic sites, ORC-based powder provides the safe, adaptable solution surgeons need.
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. Endoscopic Powder 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.