Endoscopic Powder: A Game-Changer in Haemostasis for Minimally Invasive Surgery
Securing haemostasis effectively is essential for positive surgical outcomes. Besides reducing bleeding, proper haemostasis cuts down the chances of transfusions and post-surgical issues. However, in minimally invasive surgeries (MIS)—such as laparoscopic and endoscopic procedures—haemostasis presents unique challenges due to restricted access, limited visibility, and anatomical complexity.
With the rise of less invasive surgery, adaptable and efficient haemostatic agents are more vital than ever, especially where standard techniques fail.
Why Bleeding Control in MIS is Difficult
Minimally invasive surgery provides advantages including faster healing and minimal scarring, but also presents new obstacles for bleeding control. These positive factors, however, increase the complexity of haemostasis. The lack of space, restricted visibility, and absence of tactile cues make diffuse or irregular bleeding especially tough to address.
Conventional techniques like suturing, tying off vessels, or cauterization can be difficult to use during MIS. This is where topical haemostatic products—particularly endoscopic powders—are essential for boosting visibility and rapid bleeding control.
Surgi-ORC® Powder: An Innovative Haemostatic Solution
One of the most promising powdered forms—a plant-based, absorbable haemostat with a proven safety and efficacy profile. Introduced decades ago as a sheet, oxidized regenerated cellulose (ORC) is now available in powder form for today’s MIS challenges.
Why Surgi-ORC®-Based Endoscopic Powder Stands Out
• Fast Bleeding Control: ORC speeds up clotting by promoting platelet adhesion
• Shape Plasticity: The granular structure of powdered haemostats and their shape plasticity allows them to conform easily to large and deep surface wounds
• Plant-Derived and Safe: No animal or human materials, so lower immune or infection risk
• Antibacterial Environment: The oxidation process lowers pH, creating an acidic microenvironment that offers bactericidal benefits
• Fully Absorbable: Powder dissolves safely, posing no harm to nerves or vessels
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.
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.
How Bellows Applicators Function
Syringe-style bellows devices, fitted with short or long tips, can deliver powder through MIS access points. The bellows mechanism lets surgeons deposit powder accurately without blocking the field of view.
Key Considerations for Optimal Use
• 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 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
In surgical settings where access is limited or structures are delicate, endoscopic powder proves invaluable. Because of its conformability, surgeons can treat both broad raw surfaces and deep crevices with ease.
Common Uses Include:
• Minimally invasive liver surgeries
• Cardiothoracic
• Laparoscopic gynaecologic interventions
• Submucosal dissection cases
• Urological surgeries
Endoscopic powders boost surgical efficiency by speeding up haemostasis, cutting transfusion needs, and improving results.
Clinical Evidence: Proven Performance of ORC Powder
A clinical study of SURGICEL® Powder (an ORC-based agent) on 103 patients revealed:
• 87.4% of patients had bleeding stopped in 5 minutes; 92.2% within 10 minutes
• Strong performance in open and Endoscopic Powder minimally invasive settings
• 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
This evidence supports the safety, efficiency, and flexibility of SURGICEL® Powder for difficult bleeding scenarios.
Final Thoughts
With minimally invasive surgery on the rise, there’s a growing need for innovative bleeding control solutions. ORC-based endoscopic powders offer surgeons rapid, flexible, and reliable bleeding control options.
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.