Endoscopic Powder for Haemostasis: A Breakthrough in 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. 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. But the same factors that make MIS appealing also make bleeding control more difficult. Limited maneuverability, constrained visualization, and the absence of tactile feedback make it harder to manage diffuse or irregular bleeding.
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.
Surgi-ORC® Powder: An Innovative Haemostatic Solution
Surgi-ORC® endoscopic powder is a standout, plant-derived, absorbable haemostat with robust clinical backing. 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
• 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
• Antibacterial Action: Acidic pH helps kill bacteria at the wound site
• 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 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. The bellows mechanism lets surgeons deposit powder accurately without blocking the field of view.
Key Considerations for Optimal Use
• 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 Properties: The grain size and flowability, plus moisture sensitivity, impact delivery
• 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.
Endoscopic Powder is Commonly Used For:
• Laparoscopic liver resections
• Cardiothoracic MIS cases
• Gynaecologic laparoscopic procedures
• 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].
Clinical Data Supporting ORC Powder
Research on SURGICEL® Powder in 103 surgical patients found:
• 87.4% haemostasis at 5 minutes, rising to 92.2% Endoscopic Powder at 10 minutes
• Excellent results across open and minimally invasive surgeries
• No complications linked to the product: no rebleeding, clots, or negative reactions
• Surgeons noted its ease of use, accuracy, and minimal need for extra measures
Overall, the data shows SURGICEL® Powder as a safe, effective, and adaptable haemostatic agent—especially when conventional tools aren’t enough.
Summary
The future of MIS depends on effective, next-generation haemostatic agents. ORC-based endoscopic powders offer surgeons rapid, flexible, and reliable bleeding control options.
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. 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.