The Prolene hernia system (PHS) is a three-dimensional mesh device that combines three approaches to hernia repair, but its high cost precludes its widespread use in developing countries. We describe our experience with an indigenous bilayer mesh device that works on a similar principle, and compare its efficacy with conventional PHS.A total of 84 patients with unilateral/bilateral primary uncomplicated inguinal hernia were recruited for the study over a 1-year period and randomized into two groups. Group 1, which consisted of 40 patients, received the indigenous device, and group 2, 44 patients, received conventional PHS. Mean operative time and the patients' visual assessment scores (VAS) for pain were primary outcome measures. Patient were reviewed in out patients department at intervals of 3 months, and the incidence of complications and recurrence was noted. This was the secondary outcome measure.The two group were comparable in terms of age, type of hernia, and mean duration of follow-up. The mean operative time was 32.1 min (+/- 5.5) and 33.25 (+/- 5.3) in groups 1 and 2, respectively, and the mean VAS score was 2.25 and 2.27 in the respective groups. There was no statistically significant difference. Similarly, the was no significant difference in incidence of complications noted between the two groups (3/40 versus 4/44, respectively). There were no recurrences noted during the period of observation.The indigenous bilayer device described in this study combines the advantages of two well-publicized techniques of hernia repair: inlay repair and onlay repair. It offers the benefits of conventional PHS repair but is far less expensive and is quite suitable for routine use in centers like ours in a developing nation, where financial resources are a constraint.
