Revolutionizing Bleeding Control: The Impact of Endoscopic Powder in MIS

Effective control of haemostasis is critical to the success of any surgical procedure. Besides reducing bleeding, proper haemostasis cuts down the chances of transfusions and post-surgical issues. In minimally invasive surgeries like laparoscopy or endoscopy, controlling bleeding is especially challenging due to limited space, visibility, and anatomical intricacy.

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. 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

Among haemostatic powders, plant-based, absorbable types like Surgi-ORC® have demonstrated both safety and effectiveness. Introduced decades ago as a sheet, oxidized regenerated cellulose (ORC) is now available in powder form for today’s MIS challenges.

 

 

Key Benefits of Surgi-ORC® Endoscopic Powder

• 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
• Fully Absorbable: Powder dissolves safely, posing no harm to nerves or vessels

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.

 

 

Optimizing Application with Delivery Devices in MIS

How the powder is delivered greatly influences its effectiveness in surgery. Most MIS procedures rely on bellows-type applicators for controlled and accurate powder delivery.

 

 

Operation of Endoscopic Powder Applicators

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

• Device Orientation: The angle of application (vertical/horizontal) affects how the powder spreads—often more than compression speed
• 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 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.

Typical Applications:

• Minimally invasive liver surgeries
• Cardiothoracic MIS cases
• Gynaecologic laparoscopic procedures
• Endoscopic submucosal dissections (ESD)
• Urologic procedures

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

 

 

Clinical Data Supporting 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
• Effective in both open and MIS procedures
• No product-related complications—no rebleeding, thromboembolism, or adverse reactions
• Surgeons noted its ease of use, accuracy, and minimal need for extra measures

This evidence supports the safety, efficiency, and flexibility of SURGICEL® Powder for difficult bleeding scenarios.

 

 

Final Thoughts

As MIS continues to evolve, so does the demand for advanced haemostatic tools. 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

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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.

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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.

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