Atef M. DARWISH, Dina A.M. DARWISH, Awatuf EL SHIRIF
Journal of Surgery and Medicine - 2026;10(6):0-0
Mesh repair is the standard approach for anterior abdominal wall hernias because it provides durable reinforcement and low recurrence rates. Over time, fixation techniques have evolved toward safer and less invasive methods, and metallic screw fixation has largely become obsolete. Nevertheless, older fixation techniques may still be encountered and may complicate subsequent abdominal or pelvic surgery. We report the case of a 37-year-old woman with a history of two prior cesarean sections and hernia repair with mesh fixation 11 years earlier. She presented with pelvic pain, pelvic heaviness, and abnormal uterine bleeding. Ultrasonography revealed a large posterior cervical wall leiomyoma. During open myomectomy, multiple metallic screws securing the anterior abdominal wall mesh were unexpectedly identified, requiring careful dissection, adhesiolysis, and modification of the abdominal entry technique to safely access the peritoneal cavity. The procedure was completed without complications, and the patient recovered uneventfully. This case highlights the importance of obtaining a detailed surgical history, recognizing outdated fixation techniques, using preoperative imaging when appropriate, and performing meticulous intraoperative planning to minimize risk during reoperative abdominal and gynecologic surgery.
