The Must Know Details and Updates on Endoscopic Powder
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
Minimally invasive surgery provides advantages including faster healing and minimal scarring, but also presents new obstacles for bleeding control. 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.
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.
Spotlight on Surgi-ORC®-Based Endoscopic Powder
Among haemostatic powders, plant-based, absorbable types like Surgi-ORC® have demonstrated both safety and effectiveness. 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
• 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
• Antibacterial Environment: The oxidation process lowers pH, creating an acidic microenvironment that offers bactericidal benefits
• Biocompatible and Absorbable: Completely resorbed by the body with no cytotoxic effects, even near nerves or vessels
Thanks to these features, Surgi-ORC® powder excels at controlling bleeding from small vessels in restricted surgical fields.
Optimizing Application with Delivery Devices in MIS
The choice of delivery device plays a major role in the powder’s performance during MIS. Most MIS procedures rely on bellows-type applicators for controlled and accurate powder delivery.
How It Works
Syringe-style bellows devices, fitted with short or long tips, can deliver powder through MIS access points. Compressing the bellows dispenses a controlled amount of powder right onto the bleed, maintaining clear visibility.
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
Clinical Uses of Endoscopic Powder
In cases where visibility is poor or anatomy is complex, endoscopic powder becomes an essential tool. Its adaptability allows direct application to large, raw surfaces or narrow anatomical crevices.
Typical Applications:
• Minimally invasive liver surgeries
• Cardiothoracic
• Laparoscopic gynaecologic interventions
• Submucosal dissection cases
• 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
Research on SURGICEL® Powder in 103 surgical patients found:
• 87.4% of patients had bleeding stopped in 5 minutes; 92.2% within 10 minutes
• Strong performance in open and minimally invasive settings
• No complications such as rebleeding, thromboembolism, or side effects reported
• 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.
Conclusion
The future of MIS depends on effective, next-generation haemostatic agents. Among these, ORC endoscopic powder has proven to be both efficient and easy for surgeons to use.
No matter the complexity—be it confined spaces, delicate organs, or irregular wounds—ORC endoscopic powder ensures safe, effective bleeding control for today’s surgical demands.
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 Endoscopic Powder 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.