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.

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

While MIS offers benefits such as shorter recovery and less scarring compared to open surgery, it brings new challenges. But the same factors that make MIS appealing also make bleeding control more difficult. The lack of space, restricted visibility, and absence of tactile cues make diffuse or irregular bleeding especially tough to address.

Traditional methods—sutures, ligation, or electrocautery—are often impractical in these settings. Here, topical haemostats such as endoscopic powders become essential, helping to control bleeding and improve surgical efficiency.

 

 

Spotlight on Surgi-ORC®-Based Endoscopic Powder

Among haemostatic powders, plant-based, absorbable types like Surgi-ORC® have demonstrated both safety and effectiveness. Introduced decades ago as a sheet, oxidized regenerated cellulose (ORC) is now available in powder form for today’s MIS challenges.

 

 

Key Benefits of Surgi-ORC® Endoscopic Powder

• Fast Bleeding Control: ORC speeds up clotting by promoting platelet adhesion
• 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 Action: Acidic pH helps kill bacteria at the wound site
• 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

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. The bellows mechanism lets surgeons deposit powder accurately without blocking the field of view.

 

 

Maximizing Effectiveness: Usage Tips

• Device Orientation: The angle of application (vertical/horizontal) affects how the powder spreads—often more than compression speed
• Powder Properties: The grain size and flowability, plus moisture sensitivity, impact delivery
• 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 Endoscopic Powder 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
• Thoracic surgery procedures
• Gynaecology MIS surgeries
• 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

A clinical study of SURGICEL® Powder (an ORC-based agent) on 103 patients revealed:

• 87.4% haemostasis at 5 minutes, rising to 92.2% at 10 minutes
• Effective in both open and MIS procedures
• No product-related complications—no rebleeding, thromboembolism, or adverse reactions
• Surgeons found it easy to use, highly effective, and praised the precise delivery with little extra intervention needed

These findings confirm that SURGICEL® Powder is safe, efficient, and versatile, particularly for managing mild-to-moderate bleeding where traditional methods may fall short.

 

 

Summary

The future of MIS depends on effective, next-generation haemostatic agents. Endoscopic powder, particularly ORC-based formulations, stands out as a reliable, fast-acting, and surgeon-friendly solution for bleeding control.

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.