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

Endoscopic Powder

 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. 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 [1].

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. 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 [2].

Traditional methods—sutures, ligation, or electrocautery—are often impractical in these settings. That’s where topical haemostatic agents, especially endoscopic powder, come into play as vital adjuncts to improve visibility, control oozing, and speed up procedures.

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. ORC was first introduced in 1943 in sheet form and has since evolved to meet the demands of modern MIS through powder formulations [3].

Fig.1: Surgi-ORC® endoscopic powder

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-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 [4]

These characteristics make Surgi-ORC® endoscopic powder an ideal choice for managing mild to moderate bleeding—especially capillary, venous, or small arterial oozing in confined spaces.

Delivery Devices: Enhancing Precision in MIS

The delivery method is a critical yet often overlooked factor in a powder’s haemostatic performance. In MIS, bellows pump-based applicators are widely used to deliver endoscopic powder with accuracy and control.

Fig.2: Bellow pump-based applicators

How It Works

These applicators—resembling syringe-like devices—are equipped with short or long applicator tips designed to deliver the powder through laparoscopic ports or trocars. By manually compressing the bellows, surgeons can apply a consistent amount of haemostatic agent directly onto the bleeding site without obstructing the surgical 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.
  • 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].

Real-World Applications of Endoscopic Powder

In surgical settings where access is limited or structures are delicate, endoscopic powder proves invaluable. Its adaptability allows direct application to large, raw surfaces or narrow anatomical crevices.

Common Uses Include:

  • Laparoscopic liver resections
  • Cardiothoracic
  • Gynaecologic laparoscopic procedures
  • Endoscopic submucosal dissections (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 Evidence: Proven Performance of 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
  • Excellent results across open and minimally invasive surgeries
  • 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].

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

Conclusion

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.

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