Endoscopic Powder - Knowing The Best For You

Endoscopic Powder - Knowing The Best For You

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

The ability to achieve reliable haemostasis is vital in every surgical setting. 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.

With the rise of less invasive surgery, adaptable and efficient haemostatic agents are more vital than ever, especially where standard techniques fail.

Why Bleeding Control in MIS is Difficult

Minimally invasive surgery provides advantages including faster healing and minimal scarring, but also presents new obstacles for bleeding control. These positive factors, however, increase the complexity of haemostasis. Reduced access, poor visualisation, and no sense of touch make handling bleeding in MIS more difficult.

Suturing, tying, or cauterising are not always feasible in minimally invasive procedures. Here, topical haemostats such as endoscopic powders become essential, helping to control bleeding and improve surgical efficiency.

Surgi-ORC® Powder: An Innovative Haemostatic Solution

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.

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
• Bactericidal Properties: Acidic environment inhibits bacterial growth
• 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.

Precision Application: Endoscopic Powder Delivery Devices

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.

How It Works

Bellows applicators, which look like syringes, have various tip lengths for applying powder via laparoscopic ports. The bellows mechanism lets surgeons deposit powder accurately without blocking the field of view.

Maximizing Effectiveness: Usage Tips

• Orientation: The Endoscopic Powder 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
• 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 adaptability allows direct application to large, raw surfaces or narrow anatomical crevices.

Typical Applications:

• Minimally invasive liver surgeries
• Cardiothoracic MIS cases
• Laparoscopic gynaecologic interventions
• Endoscopic submucosal dissections (ESD)
• Urologic procedures

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

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 complications such as rebleeding, thromboembolism, or side effects reported
• 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. 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.

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