{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:52:20Z","timestamp":1787028740719,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:00:00Z","timestamp":1710460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>(1) Background: With the increasing demand for repeat hepatectomy, preventing perihepatic adhesion formation following initial hepatectomy is crucial. Adhesion-preventative barriers, like the new spray-type AdSprayTM (Terumo Corporation, Tokyo, Japan), have been proposed to reduce adhesion risk. However, data on their safety in minimally invasive hepatectomy (MIH) remain scarce. This is the first prospective study to evaluate the safety and feasibility of AdSprayTM in MIH. (2) Methods: A total of 124 patients who underwent MIH with AdSprayTM and 20 controls were analyzed. Subgroup analysis according to the AdSpray\u2122 application area was conducted. Major complications were assessed using the Clavien\u2013Dindo classification. Moreover, intraperitoneal pressure during AdSpray\u2122 application was monitored in 20 cases. (3) Results: Major complications occurred in 6.4% of the patients, which was comparable to that in open hepatectomy. Intraperitoneal pressure remained stable below 12 mmHg during AdSpray\u2122 application without any complications. No significant difference in complication rates was observed among subgroups. However, a potential increase in intra-abdominal abscess formation was suspected with AdSpray\u2122 application to the resected liver surfaces. (4) Conclusions: AdSpray\u2122 can be safely used in MIH; however, further research is needed to confirm the appropriacy of using AdSpray\u2122, particularly over resected liver surfaces. Overall, AdSpray\u2122 is a promising tool for enhancing the safety of MIH.<\/jats:p>","DOI":"10.3390\/jpm14030309","type":"journal-article","created":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T09:32:30Z","timestamp":1710495150000},"page":"309","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The First Prospective Study Investigating the Safety and Feasibility of a Spray-Type Adhesion Barrier (AdSpray\u2122) in Minimally Invasive Hepatectomy: An Analysis of 124 Cases at Our Institution"],"prefix":"10.3390","volume":"14","author":[{"given":"Masayuki","family":"Kojima","sequence":"first","affiliation":[{"name":"Department of Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7674-6306","authenticated-orcid":false,"given":"Atsushi","family":"Sugioka","sequence":"additional","affiliation":[{"name":"Department of International Medical Center, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8153-2900","authenticated-orcid":false,"given":"Yutaro","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Fujita Health University School of Medicine, Nagoya 454-8509, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1002\/jhbp.405","article-title":"Comparison of laparoscopic major hepatectomy with propensity score matched open cases from the National Clinical Database in Japan","volume":"23","author":"Takahara","year":"2016","journal-title":"J. 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