The Growing Craze About the Endoscopic Powder

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


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Securing haemostasis effectively is essential for positive surgical outcomes. It not only limits blood loss during surgery but also lowers risks of transfusion and complications after the procedure. However, in minimally invasive surgeries (MIS)—such as laparoscopic and endoscopic procedures—haemostasis presents unique challenges due to restricted access, limited visibility, and anatomical complexity.

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. 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.

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-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
• 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.

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.

How It Works


Syringe-style bellows devices, fitted with short or long tips, can deliver powder through MIS access points. By manually compressing the bellows, surgeons can apply a consistent amount of haemostatic agent directly onto the bleeding site without obstructing the surgical view.

Best Practices for Using Endoscopic Powder


• 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
• Surgeon Technique: Output depends on the speed and force used when compressing the bellows

Clinical Uses of Endoscopic Powder


When working in tight spaces or near fragile tissues, endoscopic powder is especially useful. 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
• Gynaecology MIS surgeries
• Endoscopic procedures like ESD
• Minimally invasive urology 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:

• 87.4% of patients had bleeding stopped in 5 minutes; 92.2% within 10 minutes
• Excellent results across open and minimally invasive surgeries
• No complications such as rebleeding, thromboembolism, or side effects reported
• 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.

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.

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


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, Endoscopic Powder 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.

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