The Qualities of an Ideal Endoscopic Powder

Endoscopic Powder: A Game-Changer in Haemostasis for Minimally Invasive Surgery


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The ability to achieve reliable haemostasis is vital in every surgical setting. Beyond minimizing intraoperative blood loss, it significantly reduces the risks associated with transfusions and postoperative complications. In minimally invasive surgeries like laparoscopy or endoscopy, controlling bleeding is especially challenging due to limited space, visibility, and anatomical intricacy.

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


While MIS offers benefits such as shorter recovery and less scarring compared to open surgery, it brings new challenges. But the same factors that make MIS appealing also make bleeding control more difficult. 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. Here, topical haemostats such as endoscopic powders become essential, helping to control bleeding and improve surgical efficiency.

Spotlight on Surgi-ORC®-Based Endoscopic Powder


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.

Why Surgi-ORC®-Based Endoscopic Powder Stands Out


• Effective Haemostasis: ORC facilitates platelet adhesion and aggregation to accelerate clotting
• Shape Plasticity: The granular structure of powdered haemostats and their shape plasticity allows them to conform easily to large and deep surface wounds
• Plant-Derived and Safe: No animal or human materials, so lower immune or infection risk
• Bactericidal Properties: Acidic environment inhibits bacterial growth
• 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.

Optimizing Application with Delivery Devices 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.

How Bellows Applicators Function


These applicators—resembling syringe-like devices—are equipped with short or long applicator tips designed to deliver the powder through laparoscopic ports or trocars. Compressing the bellows dispenses a controlled amount of powder right onto the bleed, maintaining clear visibility.

Maximizing Effectiveness: Usage Tips


• 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

Where Endoscopic Powder Excels in Practice


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:

• Liver resections performed laparoscopically
• Cardiothoracic
• Gynaecologic laparoscopic procedures
• Submucosal dissection cases
• Urological surgeries

Using endoscopic powder helps surgeons see better, stop bleeding quicker, and complete operations faster—often with less need for transfusions and better patient outcomes.

Clinical Evidence: Proven Performance of ORC Powder


Research on SURGICEL® Powder in 103 surgical patients found:

• 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 product-related complications—no rebleeding, thromboembolism, or adverse reactions
• Surgeons found it easy to use, highly effective, and praised the precise delivery with little extra intervention needed

These findings confirm that SURGICEL® Powder is safe, efficient, and versatile, particularly for managing mild-to-moderate bleeding where traditional methods may fall short.

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.

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. Endoscopic Powder 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.

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