Revolutionizing Bleeding Control: The Impact of Endoscopic Powder in MIS
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. 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.
The Haemostatic Challenge in MIS
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. Limited maneuverability, constrained visualization, and the absence of tactile feedback make it harder to manage diffuse or irregular bleeding.
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.
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.
Why Surgi-ORC®-Based Endoscopic Powder Stands Out
• Accelerated Clotting: ORC’s mechanism enhances platelet activity and clot formation
• Adaptable Coverage: Powdered ORC easily conforms to irregular or deep wound areas
• 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
• Biodegradable and Safe: Powder is absorbed with no toxicity, even near sensitive structures
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 It Works
Syringe-style bellows devices, fitted with short or long tips, can deliver powder through MIS access points. The bellows mechanism lets surgeons deposit powder accurately without blocking the field of view.
Maximizing Effectiveness: Usage Tips
• 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.
Typical Applications:
• Laparoscopic liver resections
• Cardiothoracic
• Gynaecologic laparoscopic procedures
• Endoscopic submucosal dissections (ESD)
• Urological surgeries
Endoscopic powders boost surgical efficiency by speeding up haemostasis, cutting transfusion needs, and improving results.
Clinical Data Supporting ORC Powder
A clinical study of SURGICEL® Powder (an Endoscopic Powder ORC-based agent) on 103 patients revealed:
• Hemostasis was achieved in 87.4% of cases at 5 minutes, and 92.2% at 10 minutes
• Excellent results across open and minimally invasive surgeries
• No complications such as rebleeding, thromboembolism, or side effects reported
• Surgeons found it easy to use, highly effective, and praised the precise delivery with little extra intervention needed
Overall, the data shows SURGICEL® Powder as a safe, effective, and adaptable haemostatic agent—especially when conventional tools aren’t enough.
Summary
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.
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.