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

Effective control of haemostasis is critical to the success of any surgical procedure. It not only limits blood loss during surgery but also lowers risks of transfusion and complications after the procedure. 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

Compared to open surgeries, MIS—such as laparoscopic and endoscopic procedures—offers numerous benefits like reduced recovery time and smaller scars. But the same factors that make MIS appealing also make bleeding control more difficult. 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. This is where topical haemostatic products—particularly endoscopic powders—are essential for boosting visibility and rapid bleeding control.

 

 

Spotlight on Surgi-ORC®-Based Endoscopic Powder

Surgi-ORC® endoscopic powder is a standout, plant-derived, absorbable haemostat with robust clinical backing. 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

• 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
• Bactericidal Properties: Acidic environment inhibits bacterial growth
• Biodegradable and Safe: Powder is absorbed with no toxicity, even near sensitive structures

Thanks to these features, Surgi-ORC® powder excels at controlling bleeding from small vessels in restricted surgical fields.

 

 

Delivery Devices: Enhancing Precision in MIS

How the powder is delivered greatly influences its effectiveness in surgery. Most MIS procedures rely on bellows-type applicators for controlled and accurate powder delivery.

 

 

How It Works

Bellows applicators, which look like syringes, have various tip lengths for applying powder via laparoscopic ports. The bellows mechanism lets surgeons deposit powder accurately without blocking the field of view.

 

 

Key Considerations for Optimal Use

• Device Orientation: The angle of application (vertical/horizontal) affects how the powder spreads—often more than compression speed
• Physical Properties of Powder: Particle size, flow characteristics, and moisture sensitivity also influence output
• Operator Technique: Delivery efficiency varies based on how quickly and forcefully the bellows are compressed [5]

 

 

Real-World Applications of Endoscopic Powder

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.

Common Uses Include:

• Minimally invasive liver surgeries
• Cardiothoracic MIS cases
• Laparoscopic gynaecologic interventions
• Endoscopic procedures like ESD
• Urological surgeries

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

 

 

ORC Powder: Efficacy and Safety in Studies

Research on SURGICEL® Powder in 103 surgical patients found:

• 87.4% of patients had bleeding stopped in 5 minutes; 92.2% within 10 minutes
• Excellent results across open and minimally invasive surgeries
• 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.

 

 

Summary

The future of MIS depends on effective, next-generation haemostatic agents. Among these, ORC endoscopic powder has proven to be both efficient and easy for surgeons to use.

Whether you're managing bleeding in a deep pelvic space, a raw liver surface, or a narrow endoscopic field, ORC endoscopic powder delivers the performance and flexibility modern surgery requires—safely and effectively.

 

 

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 Endoscopic Powder 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.