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Endoscopic Powder: A Game-Changer in Haemostasis for 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
• 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
• Bactericidal Properties: Acidic environment inhibits bacterial growth
• 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.
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. 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
• 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
Real-World Applications 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.
Common Uses Include:
• Laparoscopic liver resections
• Thoracic surgery procedures
• Laparoscopic gynaecologic interventions
• Endoscopic submucosal dissections (ESD)
• Urologic procedures
Endoscopic powders boost surgical efficiency by speeding up haemostasis, cutting transfusion needs, and improving results.
Clinical Data Supporting ORC Powder
A postmarket clinical study evaluating SURGICEL® Powder (ORC-based haemostatic agent) in 103 patients undergoing various surgical procedures reported:
• 87.4% haemostasis at 5 minutes, rising to Endoscopic Powder 92.2% at 10 minutes
• Strong performance in open and minimally invasive settings
• No product-related complications—no rebleeding, thromboembolism, or adverse reactions
• 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.
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 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.