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 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
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. The lack of space, restricted visibility, and absence of tactile cues make diffuse or irregular bleeding especially tough to address.
Conventional techniques like suturing, tying off vessels, or cauterization can be difficult to use during MIS. This is where topical haemostatic products—particularly endoscopic powders—are essential for boosting visibility and rapid bleeding control.
Understanding Surgi-ORC® Endoscopic Powder
One of the most promising powdered forms—a plant-based, absorbable haemostat with a proven safety and efficacy profile. ORC was first introduced in 1943 in sheet form and has since evolved to meet the demands of modern MIS through powder formulations.
Advantages of Surgi-ORC® Endoscopic Powder
• Accelerated Clotting: ORC’s mechanism enhances platelet activity and clot formation
• 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
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 delivery method is a critical yet often overlooked factor in a powder’s haemostatic performance. Bellows pump applicators are commonly used for precise powder placement in minimally invasive settings.
Operation of Endoscopic Powder Applicators
These applicators—resembling syringe-like devices—are equipped with short or long applicator tips designed to deliver the powder through laparoscopic ports or trocars. By manually compressing the bellows, surgeons can apply a consistent amount of haemostatic agent directly onto the bleeding site without obstructing the surgical 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
• Operator Technique: Delivery efficiency varies based on how quickly and forcefully the bellows are compressed [5]
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.
Common Uses Include:
• Laparoscopic liver resections
• Cardiothoracic
• Gynaecologic laparoscopic procedures
• Endoscopic procedures like ESD
• Minimally invasive urology 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 ORC-based agent) on 103 patients revealed:
• 87.4% haemostasis at 5 minutes, rising to 92.2% at 10 minutes
• Excellent results across open and minimally invasive surgeries
• No complications linked to the product: no rebleeding, clots, or negative reactions
• Surgeons found it easy to use, highly effective, and praised the precise delivery with little extra intervention needed
This evidence supports the safety, efficiency, and flexibility of SURGICEL® Powder for difficult bleeding scenarios.
Final Thoughts
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
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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, Endoscopic Powder Plumé G. Role of hemostatic powders in the endoscopic management of gastrointestinal bleeding. World Journal of Gastrointestinal Pathophysiology. 2014 Aug 15;5(3):284.