Revolutionizing Bleeding Control: The Impact of Endoscopic Powder in MIS
Effective control of haemostasis is critical to the success of any surgical procedure. Besides reducing bleeding, proper haemostasis cuts down the chances of transfusions and post-surgical issues. 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.
Challenges of Haemostasis in Minimally Invasive Surgery
Minimally invasive surgery provides advantages including faster healing and minimal scarring, but also presents new obstacles for bleeding control. However, these benefits come with the challenge of difficult bleeding management. Reduced access, poor visualisation, and no sense of touch make handling bleeding in MIS more difficult.
Conventional techniques like suturing, tying off vessels, or cauterization can be difficult to use during MIS. That’s where topical haemostatic agents, especially endoscopic powder, come into play as vital adjuncts to improve visibility, control oozing, and speed up procedures.
Understanding Surgi-ORC® Endoscopic Powder
Surgi-ORC® endoscopic powder is a standout, plant-derived, absorbable haemostat with robust clinical backing. ORC was first introduced in 1943 in sheet form and has since evolved to meet the demands of modern MIS through powder formulations.
Why Surgi-ORC®-Based Endoscopic Powder Stands Out
• Effective Haemostasis: ORC facilitates platelet adhesion and aggregation to accelerate clotting
• Conformability: The powder’s granular shape adapts to wounds, covering both large and deep surfaces
• No Animal Content: Plant origin means reduced risk of allergic or infectious complications
• Bactericidal Properties: Acidic environment inhibits bacterial growth
• Biocompatible and Absorbable: Completely resorbed by the body with no cytotoxic effects, even near nerves or vessels
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
Clinical Uses 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 procedures like ESD
• Urological 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].
ORC Powder: Efficacy and Safety in Studies
A clinical study of SURGICEL® Powder (an ORC-based agent) on 103 patients revealed:
• Hemostasis was achieved in 87.4% of cases at 5 minutes, and 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 rated it highly effective and easy to use, with precise powder delivery and minimal need for additional intervention [3]
This evidence supports the safety, efficiency, and flexibility of SURGICEL® Powder for difficult bleeding scenarios.
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
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 Endoscopic Powder 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.