. A manual of gynæcology and pelvic surgery, for students and practitioners. 150.^—Intra-abdominal shortening of the round ligaments. _ The Baldy-Webster operation. One ligament has been sewn to the posterior wall of theuterus just below the fundus. The second ligament is ready for suturing. A modification of this operation consists in stitching theposterior layers of the broad ligaments to the posterior surfaceof the uterus simultaneously with the attachment of the roundligaments thereto, and by still another modification the liga-ments are drawn through a tunnel between the peritoneal andmus
. A manual of gynæcology and pelvic surgery, for students and practitioners. 150.^—Intra-abdominal shortening of the round ligaments. _ The Baldy-Webster operation. One ligament has been sewn to the posterior wall of theuterus just below the fundus. The second ligament is ready for suturing. A modification of this operation consists in stitching theposterior layers of the broad ligaments to the posterior surfaceof the uterus simultaneously with the attachment of the roundligaments thereto, and by still another modification the liga-ments are drawn through a tunnel between the peritoneal andmuscular coats of the posterior uterine wall in order to avoidthe formation of adhesions. THE BALDY-WEBSTER OPERATION 305 While other methods of intra-abdominal shortening of theround ligaments are possible, such as folding them in front of theuterus, or folding them upon themselves during their coursethrough the broad ligament, none of them present the ad-vantages of the above-described posterior method. The onlydisadvantage of the operation has been mentioned before, and. Fig. 151.—Intra-abdominal shortening of the round ligaments. The Baldy-Webster operation. Both ligaments have been stitched to the posterior uterinewall. The ligaments^have been stitched to the margins of the openings in thebroad ligaments to obviate possible intestinal strangulation. lies in the fact that the outer weaker extremities of the ligaments ; support the weight of the uterus. This is probably more than I compensated by the fact that the round ligaments now have j their uterine attachments on the posterior surface of the uterine body, whereas they are normally attached a trifle anterior to the mid-line. The forward pull upon the uterus which is secured by this operation has a mechanical advantage that is 3o6 OPEEATIONS UPON THE UTERUS AND ITS LIGAMENTS not gained by any other operation so far devised, in that itthrows the uterus so far anteriorly as to permit intra-abdominalpressure to act on the
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