affecting a decided change in the direction of traction. The operation has the disadvantage that it requires extensive dissection and handling of tissues deep in the abdominal wall.
Of the various methods of utilizing the round ligaments after the abdomen is open, the one I have found most useful is practically the Gilliam-Ferguson operation. Instead of following the usual technic, however, I find that the work can be more conveniently and expeditiously executed by passing a puncturing tenaculum forceps (Fig. 1) through the wall, grasping the ligament directly and bringing it out along the forceps track. The exact technic preferred for the class of cases under consideration is shown in detail in the following steps:
1. The special work for which the abdominal cavity was opened having been completed, the left round ligament is grasped with an ordinary tenaculum forceps about 1½ inches from the uterus. The right ligament is