The Blog on Endoscopic Powder
Endoscopic Powder for Haemostasis: A Breakthrough in Minimally Invasive Surgery
The ability to achieve reliable haemostasis is vital in every surgical setting. 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
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
• 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
• Antibacterial Action: Acidic pH helps kill bacteria at the wound site
• Biodegradable and Safe: Powder is absorbed with no toxicity, even near sensitive structures
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 delivery method is a critical yet often overlooked factor in a powder’s haemostatic performance. Bellows pump applicators are commonly used for precise powder placement in minimally invasive settings.
Operation of Endoscopic Powder Applicators
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.
Key Considerations for Optimal Use
• Device Orientation: The angle of application (vertical/horizontal) affects how the powder spreads—often more than compression speed
• 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
Where Endoscopic Powder Excels in Practice
When working in tight spaces or near fragile tissues, endoscopic powder is especially useful. Its adaptability allows direct application to large, raw surfaces or narrow anatomical crevices.
Endoscopic Powder is Commonly Used For:
• Laparoscopic liver resections
• Cardiothoracic MIS cases
• Gynaecology MIS surgeries
• Endoscopic submucosal dissections (ESD)
• Minimally invasive urology 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:
• 87.4% of patients had bleeding stopped in 5 minutes; 92.2% within 10 minutes
• Excellent results across open and minimally invasive surgeries
• 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
This evidence supports the safety, efficiency, and flexibility of SURGICEL® Powder for difficult bleeding scenarios.
Summary
With minimally invasive surgery on the rise, there’s a growing need for innovative bleeding control solutions. ORC-based endoscopic powders offer surgeons rapid, flexible, and reliable bleeding control options.
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. Safety and hemostatic effectiveness of SURGICEL® powder Endoscopic 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.