Intraabdominal  shortening  of  the  round  ligaments  possesses  the  advan-
tages of  hyslerorrhaphy  and  the  .\lexandcr  oficration  and  the  disadvantages
of  neither  OiKrations  which  shorten  these  ligaments  by  folding  them  on
thcm.selves,  by  fastening  them  to  the  anterior  surface  of  the  uterus,  or  by
drawing  them  through  the  broad  ligament  and  fastening  them  together  behind
the  uterus,  arc  objectionable  in  that  the  greatest  strain  is  brought  to  bear  upon
the  weakest  fxirtion  of  the  round  ligament  in  the  inguinal  canal.  The  CiUiam-
Ferguson  operation  utilizes  the  strongest  part  of  the  ligament.  After  opening
the  abdomen  in  the  median  line  a  [>air  of  forceps  is  pushed  through  the  outer
edge  of  the  rectus  muscle,  and  the  round  ligament  grasj)ed  about  two  inches
from  its  uterine  end;  the  forceps  is  withdrawn,  and  the  ligament  sutured  to
tlic  fascia  covering  the  rectus  muscle.  Montgomery  has  modified  the  Simpson
operation.  A  silk  ligature  is  passed  beneath  each  round  ligament  about  one
and  one-half  inches  from  the  uterus.  The  two  ends  of  one  of  these  ligatures  is
threaded  into  a  fjcdiclc  needle,  which  is  introduced  between  the  layers  of  the
broad  ligament,  and  carried  forward  e3rtraj)eritoncally  until  it  amches  the  rectus
mu.sclc,  through  which  it  is  thrust,  the  round  ligament  being  rendered  tftui
to  facilitate  this  maneuver.  The  ligature  is  withdrawn  from  the  needle,  and
serves  to  pull  the  ligament  through  the  abdominal  wall,  where  it  is  fastened
by  calgut  sutures.
