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Revolutionizing Bleeding Control: The Impact of Endoscopic Powder in MIS


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Effective control of haemostasis is critical to the success of any surgical procedure. 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 more procedures move toward minimally invasive methods, there’s a greater demand for flexible, effective bleeding control solutions when traditional methods aren’t enough.

The Haemostatic Challenge in MIS


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. The lack of space, restricted visibility, and absence of tactile cues make diffuse or irregular bleeding especially tough to address.

Traditional methods—sutures, ligation, or electrocautery—are often impractical in these settings. This is where topical haemostatic products—particularly endoscopic powders—are essential for boosting visibility and rapid bleeding control.

Understanding Surgi-ORC® Endoscopic Powder


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.

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-Based Safety: Free from animal or human components, it reduces risks of immune reactions and disease transmission
• 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

With these properties, Surgi-ORC® endoscopic powder is perfect for mild-to-moderate bleeding, particularly from capillaries, veins, or small arteries in hard-to-reach areas.

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


Bellows applicators, which look like syringes, have various tip lengths for applying powder via laparoscopic ports. Compressing the bellows dispenses a controlled amount of powder right onto the bleed, maintaining clear visibility.

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
• Physical Properties of Powder: Particle size, flow characteristics, and moisture sensitivity also influence output
• Operator Technique: Delivery efficiency varies based on how quickly and forcefully the bellows are compressed [5]

Clinical Uses of Endoscopic Powder


In surgical settings where access is limited or structures are delicate, endoscopic powder proves invaluable. Because of its conformability, surgeons can treat both broad raw surfaces and deep crevices with ease.

Endoscopic Powder is Commonly Used For:

• Minimally invasive liver surgeries
• Thoracic surgery procedures
• Gynaecologic laparoscopic procedures
• Submucosal dissection cases
• Urological surgeries

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

ORC Powder: Efficacy and Safety in Studies


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
• Excellent results across open and minimally invasive surgeries
• No product-related complications—no rebleeding, thromboembolism, or adverse 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


As MIS continues to evolve, so does the demand for advanced haemostatic tools. Endoscopic powder, particularly ORC-based formulations, stands out as a reliable, fast-acting, and surgeon-friendly solution for bleeding control.

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 Endoscopic Powder 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.

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