THE MOST SPOKEN ARTICLE ON ENDOSCOPIC POWDER

The Most Spoken Article on Endoscopic Powder

The Most Spoken Article on Endoscopic Powder

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Revolutionizing Bleeding Control: The Impact of Endoscopic Powder in MIS


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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. Yet, minimally invasive surgeries—like laparoscopic and endoscopic interventions—make bleeding control more complex because of restricted maneuverability and visibility.

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

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. These positive factors, however, increase the complexity of haemostasis. The lack of space, restricted visibility, and absence of tactile cues make diffuse or irregular bleeding especially tough to address.

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.

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. 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


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


Syringe-style bellows devices, fitted with short or long tips, can deliver powder through MIS access points. Compressing the bellows dispenses a controlled amount of powder right onto the bleed, maintaining clear visibility.

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: Endoscopic Powder 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


In cases where visibility is poor or anatomy is complex, endoscopic powder becomes an essential tool. 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
• 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
• 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


The future of MIS depends on effective, next-generation haemostatic agents. 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 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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