Endoscopic Powder for Haemostasis: A Breakthrough in Minimally Invasive Surgery

The ability to achieve reliable haemostasis is vital in every surgical setting. Besides reducing bleeding, proper haemostasis cuts down the chances of transfusions and post-surgical issues. In minimally invasive surgeries like laparoscopy or endoscopy, controlling bleeding is especially challenging due to limited space, visibility, and anatomical intricacy.

As more procedures move toward minimally invasive methods, there’s a greater demand for flexible, effective bleeding control solutions when traditional methods aren’t enough.

 

 

Challenges of Haemostasis in Minimally Invasive Surgery

While MIS offers benefits such as shorter recovery and less scarring compared to open surgery, it brings new challenges. These positive factors, however, increase the complexity of haemostasis. Limited maneuverability, constrained visualization, and the absence of tactile feedback make it harder to manage diffuse or irregular bleeding.

Conventional techniques like suturing, tying off vessels, or cauterization can be difficult to use during MIS. Here, topical haemostats such as endoscopic powders become essential, helping to control bleeding and improve surgical efficiency.

 

 

Surgi-ORC® Powder: An Innovative Haemostatic Solution

Among haemostatic powders, plant-based, absorbable types like Surgi-ORC® have demonstrated both safety and effectiveness. 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

• Fast Bleeding Control: ORC speeds up clotting by promoting platelet adhesion
• Conformability: The powder’s granular shape adapts to wounds, covering both large and deep surfaces
• 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

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.

 

 

Delivery Devices: Enhancing Precision in MIS

The choice of delivery device plays a major role in the powder’s performance during MIS. In MIS, bellows pump-based applicators are widely used to deliver endoscopic powder with accuracy and control.

 

 

Operation of Endoscopic Powder Applicators

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
• Operator Technique: Delivery efficiency varies based on how quickly and forcefully the bellows are compressed [5]

 

 

Real-World Applications 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.

Endoscopic Powder is Commonly Used For:

• Laparoscopic liver resections
• Cardiothoracic MIS cases
• Gynaecology MIS surgeries
• Endoscopic procedures like ESD
• Urologic procedures

Endoscopic powders boost surgical efficiency by speeding up haemostasis, cutting transfusion needs, and improving results.

 

 

Clinical Evidence: Proven Performance of ORC Powder

A clinical study of SURGICEL® Powder (an ORC-based agent) on 103 patients revealed:

• 87.4% of patients had bleeding stopped in 5 minutes; 92.2% within 10 minutes
• Excellent results across open and minimally invasive surgeries
• No complications such as rebleeding, thromboembolism, or side effects reported
• Surgeons rated it highly effective and easy to use, with precise powder delivery and minimal need for additional intervention [3]

Overall, the data shows SURGICEL® Powder as a safe, effective, and adaptable haemostatic agent—especially when conventional tools aren’t enough.

 

 

Summary

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 Endoscopic Powder 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.