Endoscopic Powder for Haemostasis: A Breakthrough in Minimally Invasive Surgery
The ability to achieve reliable haemostasis is vital in every surgical setting. Beyond minimizing intraoperative blood loss, it significantly reduces the risks associated with transfusions and postoperative complications. Yet, minimally invasive surgeries—like laparoscopic and endoscopic interventions—make bleeding control more complex because of restricted maneuverability and visibility.
As surgical techniques continue to shift toward less invasive approaches, the need for effective, adaptable haemostatic solutions becomes increasingly critical—especially when conventional methods fall short.
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. This is where topical haemostatic products—particularly endoscopic powders—are essential for boosting visibility and rapid bleeding control.
Understanding Surgi-ORC® Endoscopic Powder
Among haemostatic powders, plant-based, absorbable types like Surgi-ORC® have demonstrated both safety and effectiveness. Originally launched as a sheet in 1943, ORC has now been adapted into powder to address the needs of current minimally invasive surgeries.
Why Surgi-ORC®-Based Endoscopic Powder Stands Out
• Fast Bleeding Control: ORC speeds up clotting by promoting platelet adhesion
• Conformability: The powder’s granular shape adapts to wounds, covering both large and deep surfaces
• Plant-Based Safety: Free from animal or human components, it reduces risks of immune reactions and disease transmission
• Bactericidal Properties: Acidic environment inhibits bacterial growth
• Fully Absorbable: Powder dissolves safely, posing no harm to nerves or vessels
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.
Optimizing Application with Delivery Devices in MIS
The choice of delivery device plays a major role in the powder’s performance during MIS. In MIS, bellows pump-based applicators are widely used to deliver endoscopic powder with accuracy and control.
How Bellows Applicators Function
These applicators—resembling syringe-like devices—are equipped with short or long applicator tips designed to deliver the powder through laparoscopic ports or trocars. By manually compressing the bellows, surgeons can apply a consistent amount of haemostatic agent directly onto the bleeding site without obstructing the surgical view.
Maximizing Effectiveness: Usage Tips
• Orientation: How you hold the device (vertically or horizontally) influences powder distribution more than how hard you squeeze
• Powder Characteristics: Particle size, flow, and how the powder handles moisture will affect performance
• Operator Technique: Delivery efficiency varies based on how quickly and forcefully the bellows are compressed [5]
Where Endoscopic Powder Excels in Practice
In surgical settings where access is limited or structures are delicate, endoscopic powder proves invaluable. Its flexible form lets it cover both wide wounds and tight spaces with equal efficiency.
Typical Applications:
• Laparoscopic liver resections
• Cardiothoracic MIS cases
• Laparoscopic gynaecologic interventions
• Submucosal dissection cases
• Urologic procedures
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:
• Hemostasis was achieved in 87.4% of cases at 5 minutes, and 92.2% at 10 minutes
• Effective in both open and MIS procedures
• No complications such as rebleeding, thromboembolism, or side effects reported
• Surgeons noted its ease of use, accuracy, and minimal need for extra measures
This evidence supports the safety, efficiency, and flexibility of SURGICEL® Powder for difficult bleeding scenarios.
Summary
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.
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 Endoscopic Powder 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.