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. Yet, minimally invasive surgeries—like laparoscopic and endoscopic interventions—make bleeding control more complex because of restricted maneuverability and visibility.
With the rise of less invasive surgery, adaptable and efficient haemostatic agents are more vital than ever, especially where standard techniques fail.
The Haemostatic Challenge in MIS
Minimally invasive surgery provides advantages including faster healing and minimal scarring, but also presents new obstacles for bleeding control. 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.
Suturing, tying, or cauterising are not always feasible in minimally invasive procedures. That’s where topical haemostatic agents, especially endoscopic powder, come into play as vital adjuncts to improve visibility, control oozing, and speed up procedures.
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. 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
• Accelerated Clotting: ORC’s mechanism enhances platelet activity and clot formation
• 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
• Biocompatible and Absorbable: Completely resorbed by the body with no cytotoxic effects, even near nerves or vessels
Thanks to these features, Surgi-ORC® powder excels at controlling bleeding from small vessels in restricted surgical fields.
Precision Application: Endoscopic Powder Delivery Devices
How the powder is delivered greatly influences its effectiveness in surgery. Bellows pump applicators are commonly used for precise powder placement in minimally invasive settings.
How It Works
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.
Maximizing Effectiveness: Usage Tips
• 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
• 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]
Clinical Uses of Endoscopic Powder
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
• Gynaecologic laparoscopic procedures
• Endoscopic submucosal dissections (ESD)
• Urologic procedures
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
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
• Strong performance in open and minimally invasive settings
• No complications linked to the product: no rebleeding, clots, or negative 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.
Conclusion
With minimally invasive surgery on the rise, there’s a growing need for innovative bleeding control solutions. 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
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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 Endoscopic Powder Aug 15;5(3):284.