Endoscopic Powder for Haemostasis: A Breakthrough in 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.

 

 

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
• 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

The choice of delivery device plays a major role in the powder’s performance during MIS. Bellows pump applicators are commonly used for precise powder placement in minimally invasive settings.

 

 

How Bellows Applicators Function

Bellows applicators, which look like syringes, have various tip lengths for applying powder via laparoscopic ports. Compressing the bellows dispenses a controlled amount of powder right onto the bleed, maintaining clear visibility.

 

 

Maximizing Effectiveness: Usage Tips

• 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 adaptability allows direct application to large, raw surfaces or narrow anatomical crevices.

Typical Applications:

• Minimally invasive liver surgeries
• Cardiothoracic MIS cases
• Gynaecologic laparoscopic procedures
• Submucosal dissection cases
• Urologic procedures

Endoscopic powders boost surgical efficiency by speeding up haemostasis, cutting transfusion needs, and improving results.

 

 

Clinical Data Supporting ORC Powder

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 product-related complications—no rebleeding, thromboembolism, or adverse reactions
• Surgeons noted its ease of use, accuracy, and minimal need for extra measures

Overall, the data shows SURGICEL® Powder as a safe, effective, and adaptable haemostatic agent—especially when conventional tools aren’t enough.

 

 

Final Thoughts

As MIS continues to evolve, so does the demand for advanced haemostatic tools. 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

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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 Endoscopic Powder powdered oxidized regenerated cellulose and starch-based powder formulations. Research and Practice in Thrombosis and Haemostasis. 2025 Jan 1;9(1):102668.

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