Objective <p>Reduction of bleeding and prolonged air leak (&gt;5 days) following major lung resection remains a challenge. Hemostasis and aerostasis devices can facilitate earlier pleural de-drainage and fast-track. Our objectives were to evaluate the efficacy of TenaTac^® (an elastic, adhering patch approved as a medical device) in reducing bleeding and prolonged air leak after major lung resection.</p> Methods <p>This monocentric retrospective case–control study, using prospectively collected data, includes 60 patients who underwent, between 2022 and 2024, minimally invasive robot-assisted lobectomy or segmentectomy: 30 with TenaTac^® <i>vs.</i> 30 with other devices. Data were extracted from Epithor, the French national database, with ethics committee validation.</p> Results <p>Patients characteristics, Index of Prolonged Air Leak, and surgical procedures were similar in both groups (NS). TenaTac^® hemostatic benefit was comparable to other devices (<i>p</i> = 0.56). Prolonged air leak rate was significantly lower with TenaTac^® (3%) than for control devices (37%) (<i>p</i> = 0.0004). Post-operative air leakage duration was significantly shorter in TenaTac^® group than in control group (2.23 ± 2.57 <i>vs.</i> 4.23 ± 3.87 days, <i>p</i> = 0.01). Mean drainage duration and length of stay were both reduced with TenaTac^® by 36 hours. No significant difference was observed between the two groups in terms of morbidity (90-day post-operative complications classified as Clavien–Dindo grade&gt;II, <i>p</i> = 0.33), readmission rates (nil), or 90-day mortality (no deaths).</p> Conclusions <p>Numerous hemostatic or aerostatic devices have been previously evaluated without achieving consensus in the prevention of prolonged air leak. As an absorbable, adherent gelatine patch, TenaTac^® significantly reduces the incidence of prolonged air leak after major lung resection.</p>