Article to Know on Endoscopic Powder and Why it is Trending?

Endoscopic Powder for Haemostasis: A Breakthrough in Minimally Invasive Surgery

Securing haemostasis effectively is essential for positive surgical outcomes. 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.

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

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. Reduced access, poor visualisation, and no sense of touch make handling bleeding in MIS more difficult.

Traditional methods—sutures, ligation, or electrocautery—are often impractical in these settings. 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

• Fast Bleeding Control: ORC speeds up clotting by promoting platelet adhesion
• 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 Action: Acidic pH helps kill bacteria at the wound site
• Fully Absorbable: Powder dissolves safely, posing no harm to nerves or vessels

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
• Physical Properties of Powder: Particle size, flow characteristics, and moisture sensitivity also influence output
• 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. Because of its conformability, surgeons can treat both broad raw surfaces and deep crevices with ease.

Endoscopic Powder is Commonly Used For:

• Laparoscopic liver resections
• Thoracic surgery procedures
• Gynaecology MIS surgeries
• Endoscopic procedures like 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].

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
• Strong performance in open and minimally invasive settings
• No complications linked to the product: no rebleeding, clots, or negative reactions
• Surgeons rated it highly effective and easy to use, with precise powder delivery and minimal need for additional intervention [3]

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

Conclusion

With minimally invasive surgery on the rise, there’s a growing need for innovative bleeding control solutions. Endoscopic powder, particularly ORC-based formulations, stands out as a reliable, fast-acting, and surgeon-friendly solution for bleeding control.

From deep pelvic cavities to exposed liver surfaces or tight endoscopic sites, ORC-based powder provides the safe, adaptable solution surgeons need.

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 Endoscopic Powder 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.