OBJECTIVES: Persistent air leaks after lung resection surgery often lead to increased complications including longer length of hospital stay and resulting treatment costs. A PEG hydrogel sealant (PleuraSeal™) is used as an adjunct to standard closure of pleural air leaks during lung resection surgery and has demonstrated shorter hospitalizations (1.7 fewer days; Wain JC et al, 2008, Conference Abstract) and more rapid removal of chest tubes in a clinical study (Covidien, data on file) when compared with standard closure (e.g. staples and sutures alone). Our study was designed to estimate the potential cost offsets for using PleuraSeal™ compared with standard closure in 100 hypothetical patients from a Spanish hospital who had an air leak after lung resection surgery using the cost offset from shorter hospital stays balanced against the cost for PleuraSeal™. METHODS: We assumed the cost for PleuraSeal™ in Spain to be €420 per treatment applied to all 100 hypothetical patients compared with no added cost for standard closure. We then balanced the added cost for PleuraSeal™ with the reduction in number of hospital days and subsequent costs (€590/day [Varela et al, 2006] @1.7 fewer days per patient) compared with standard closure and calculated the potential cost offset for PleuraSeal™. RESULTS: A Spanish hospital that performs 100 lung resections with air leaks can expect to save €58,300, or approximately €583 per patient when compared to standard closure as patients who had air leaks stayed in hospital an average of 1.7 days longer than those without air leaks.  CONCLUSIONS: The cost for PleuraSeal™ is completely offset by the shorter length of hospital stay compared with standard closure inSpain. PleuraSeal™ is a compelling option for Spanish hospitals that perform lung resection surgeries as the cost of the treatment is completely offset by the reduction in air leaks and subsequent shorter hospital stay.