Endoscopic Powder: A Game-Changer in Haemostasis for Minimally Invasive Surgery
Securing haemostasis effectively is essential for positive surgical outcomes. 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.
Challenges of Haemostasis in Minimally Invasive Surgery
While MIS offers benefits such as shorter recovery and less scarring compared to open surgery, it brings new challenges. 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.
Traditional methods—sutures, ligation, or electrocautery—are often impractical in these settings. That’s where topical haemostatic agents, especially endoscopic powder, come into play as vital adjuncts to improve visibility, control oozing, and speed up procedures.
Surgi-ORC® Powder: An Innovative Haemostatic Solution
Surgi-ORC® endoscopic powder is a standout, plant-derived, absorbable haemostat with robust clinical backing. Originally launched as a sheet in 1943, ORC has now been adapted into powder to address the needs of current minimally invasive surgeries.
Key Benefits of Surgi-ORC® Endoscopic Powder
• Effective Haemostasis: ORC facilitates platelet adhesion and aggregation to accelerate clotting
• 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
• Antibacterial Environment: The oxidation process lowers pH, creating an acidic microenvironment that offers bactericidal benefits
• Biodegradable and Safe: Powder is absorbed with no toxicity, even near sensitive structures
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.
Delivery Devices: Enhancing Precision in MIS
The choice of delivery device plays a major role in the powder’s performance during MIS. Most MIS procedures rely on bellows-type applicators for controlled and accurate powder delivery.
Operation of Endoscopic Powder Applicators
Bellows applicators, which look like syringes, have various tip lengths for applying powder via laparoscopic ports. By manually compressing the bellows, surgeons can apply a consistent amount of haemostatic agent directly onto the bleeding site without obstructing the surgical view.
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
• 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:
• Laparoscopic liver resections
• Cardiothoracic MIS cases
• Gynaecologic laparoscopic procedures
• 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].
Clinical Data Supporting ORC Powder
Research on SURGICEL® Powder in 103 surgical patients found:
• 87.4% haemostasis at 5 minutes, rising to 92.2% at 10 minutes
• Effective in both open and MIS procedures
• No complications such as rebleeding, thromboembolism, or side effects reported
• Surgeons rated it highly effective and easy Endoscopic Powder to use, with precise powder delivery and minimal need for additional intervention [3]
Overall, the data shows SURGICEL® Powder as a safe, effective, and adaptable haemostatic agent—especially when conventional tools aren’t enough.
Conclusion
As MIS continues to evolve, so does the demand for advanced haemostatic tools. Endoscopic powder, particularly ORC-based formulations, stands out as a reliable, fast-acting, and surgeon-friendly solution for bleeding control.
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. 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.