Revolutionizing Bleeding Control: The Impact of Endoscopic Powder in MIS
Effective control of haemostasis is critical to the success of any surgical procedure. 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.
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.
The Haemostatic Challenge in MIS
While MIS offers benefits such as shorter recovery and less scarring compared to open surgery, it brings new challenges. 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.
Conventional techniques like suturing, tying off vessels, or cauterization can be difficult to use during MIS. 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
Among haemostatic powders, plant-based, absorbable types like Surgi-ORC® have demonstrated both safety and effectiveness. 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
• Effective Haemostasis: ORC facilitates platelet adhesion and aggregation to accelerate clotting
• 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
• Biodegradable and Safe: Powder is absorbed with no toxicity, even near sensitive structures
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.
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.
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
• Surgeon Technique: Output depends on the speed and force used when compressing the bellows
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.
Common Uses Include:
• Liver resections performed laparoscopically
• Thoracic surgery procedures
• Gynaecologic laparoscopic procedures
• 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.
ORC Powder: Efficacy and Safety in Studies
A postmarket clinical study evaluating SURGICEL® Powder (ORC-based haemostatic agent) in 103 patients undergoing various surgical procedures reported:
• 87.4% of patients had bleeding stopped in 5 minutes; 92.2% within 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.
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
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