Endoscopic Powder for Haemostasis: A Breakthrough in Minimally Invasive Surgery
Securing haemostasis effectively is essential for positive surgical outcomes. Beyond minimizing intraoperative blood loss, it significantly reduces the risks associated with transfusions and postoperative complications. 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.
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. Reduced access, poor visualisation, and no sense of touch make handling bleeding in MIS more difficult.
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
One of the most promising powdered forms—a plant-based, absorbable haemostat with a proven safety and efficacy profile. Originally launched as a sheet in 1943, ORC has now been adapted into powder to address the needs of current minimally invasive surgeries.
Advantages of Surgi-ORC® Endoscopic Powder
• 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-Based Safety: Free from animal or human components, it reduces risks of immune reactions and disease transmission
• Antibacterial Environment: The oxidation process lowers pH, creating an acidic microenvironment that offers bactericidal benefits
• Biocompatible and Absorbable: Completely resorbed by the body with no cytotoxic effects, even near nerves or vessels
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.
Optimizing Application with Delivery Devices 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. 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
• Surgeon Technique: Output depends on the speed and force used when compressing the bellows
Clinical Uses of Endoscopic Powder
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.
Typical Applications:
• Minimally invasive liver surgeries
• Cardiothoracic MIS cases
• Laparoscopic gynaecologic interventions
• 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 Evidence: Proven Performance of ORC Powder
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
• Excellent results across open and minimally invasive surgeries
• 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. 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. Endoscopic Powder 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.