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.

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. These positive factors, however, increase the complexity of haemostasis. The lack of space, restricted visibility, and absence of tactile cues make diffuse or irregular bleeding especially tough to address.

Suturing, tying, or cauterising are not always feasible in minimally invasive procedures. This is where topical haemostatic products—particularly endoscopic powders—are essential for boosting visibility and rapid bleeding control.

 

 

Surgi-ORC® Powder: An Innovative Haemostatic Solution

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

How the powder is delivered greatly influences its effectiveness in surgery. 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. The bellows mechanism lets surgeons deposit powder accurately without blocking the field of view.

 

 

Key Considerations for Optimal Use

• Orientation: How you hold the device (vertically or horizontally) influences powder distribution more than how hard you squeeze
• Physical Properties of Powder: Particle size, flow characteristics, and moisture sensitivity also influence output
• Surgeon Technique: Output depends on the speed and force used when compressing the bellows

 

 

Clinical Uses of Endoscopic Powder

When working in tight spaces or near fragile tissues, endoscopic powder is especially useful. Because of its conformability, surgeons can treat both broad raw surfaces and deep crevices with ease.

Endoscopic Powder is Commonly Used For:

• Laparoscopic liver resections
• Cardiothoracic
• Gynaecology MIS surgeries
• Endoscopic procedures like ESD
• Minimally invasive urology surgeries

Using endoscopic powder helps surgeons see better, stop bleeding quicker, and complete operations faster—often with less need for transfusions and better patient outcomes.

 

 

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
• 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.

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 Endoscopic Powder 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.