If an aseptic operation has been performed, and there is no intestinal lesion and hemostasis is perfect, drainage is not required. This condition of things is, of course, most often attained by the experienced operator. If the operator fears septic infection for any reason, or fears that the hemostasis is not good, he should employ drainage. At the present day the decided majority of the best operators use abdominal drainage very little. When general peritoneal sepsis exists before the abdomen is opened, drainage is always indicated. =Vaginal Drainage.=--Drainage of the peritoneum through the vagina is usually accomplished by making an opening through Douglas’s pouch into the posterior vaginal fornix. A rubber drainage-tube or a gauze drain may then be inserted. The vagina and vulva should, of course, have been thoroughly sterilized. The vagina should be lightly packed with gauze, and the vulva should be protected by a gauze and cotton dressing. As has been said, the chief objection to vaginal drainage of the peritoneum is the difficulty of sterilizing and maintaining sterile the vagina and the vulva. =The Incision of the Abdominal Wall.=--The various abdominal operations of gynecology are performed through an incision in the median line. The position of the incision depends upon the condition to be treated. The incision for performing ventro-suspension of the uterus is made near to the symphysis pubis. The incision for the removal of a large cyst is made at a higher point. As a rule, the incision, about 2 or 2½ inches in length, should be made about midway between the umbilicus and the pubis, and should be extended upward or downward as necessary. The incision should be as small as the operator can conveniently work through. He should not hesitate to enlarge the incision to facilitate any manipulations. The length will depend a good deal upon the thickness of the abdominal walls. The structures that are incised are the skin, the subcutaneous fat, the parietal fascia, the linea alba or the edge of the rectus muscle, the subperitoneal fat, and the peritoneum. If the incision is made exactly in the median line, the linea alba will be divided and the sheath of the rectus will not be opened. This is most usual in multiparous women with lax abdominal walls and widely separated recti muscles, and in cases in which the abdomen is distended by a tumor. If the sheath of the rectus is opened, the muscle will be exposed, and the linea alba should be sought on the side upon which the fascia fails to retract. If the linea alba cannot readily be found, the incision should be carried directly through the muscle. Some operators consider it an advantage, in obtaining subsequent firm union, to expose the muscle in this way. When the subperitoneal fat is reached, it should be torn and pushed aside with the blunt closed forceps or with the fingers.