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.

 

 

The Haemostatic Challenge in MIS

Compared to open surgeries, MIS—such as laparoscopic and endoscopic procedures—offers numerous benefits like reduced recovery time and smaller scars. 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. This is where topical haemostatic products—particularly endoscopic powders—are essential for boosting visibility and rapid bleeding control.

 

 

Surgi-ORC® Powder: An Innovative Haemostatic Solution

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.

 

 

Key Benefits of Surgi-ORC® Endoscopic Powder

• Fast Bleeding Control: ORC speeds up clotting by promoting platelet adhesion
• Shape Plasticity: The granular structure of powdered haemostats and their shape plasticity allows them to conform easily to large and deep surface wounds
• Plant-Based Safety: Free from animal or human components, it reduces risks of immune reactions and disease transmission
• Antibacterial Action: Acidic pH helps kill bacteria at the wound site
• Fully Absorbable: Powder dissolves safely, posing no harm to nerves or vessels

Thanks to these features, Surgi-ORC® powder excels at controlling bleeding from small vessels in restricted surgical fields.

 

 

Precision Application: Endoscopic Powder Delivery Devices

The delivery method is a critical yet often overlooked factor in a powder’s haemostatic performance. Most MIS procedures rely on bellows-type applicators for controlled and accurate powder delivery.

 

 

Operation of Endoscopic Powder Applicators

Syringe-style bellows devices, fitted with short or long Endoscopic Powder tips, can deliver powder through MIS access points. Compressing the bellows dispenses a controlled amount of powder right onto the bleed, maintaining clear visibility.

 

 

Maximizing Effectiveness: Usage Tips

• Orientation: The angle of device orientation (vertical vs. horizontal) has a significant impact on the amount and spread of the powder. Surprisingly, orientation often affects performance more than the speed or force of compression
• Powder Characteristics: Particle size, flow, and how the powder handles moisture will affect performance
• Application Style: The surgeon’s technique and compression force also influence powder delivery

 

 

Where Endoscopic Powder Excels in Practice

In cases where visibility is poor or anatomy is complex, endoscopic powder becomes an essential tool. Its flexible form lets it cover both wide wounds and tight spaces with equal efficiency.

Typical Applications:

• Liver resections performed laparoscopically
• Cardiothoracic MIS cases
• Gynaecologic laparoscopic procedures
• Endoscopic submucosal dissections (ESD)
• Urologic procedures

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

 

 

Clinical Data Supporting ORC Powder

A postmarket clinical study evaluating SURGICEL® Powder (ORC-based haemostatic agent) in 103 patients undergoing various surgical procedures reported:

• 87.4% haemostasis at 5 minutes, rising to 92.2% at 10 minutes
• Effective in both open and MIS procedures
• No product-related complications—no rebleeding, thromboembolism, or adverse 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 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.