If bleeding from the bed of the tumor cannot be thoroughly arrested, it is unsafe to close the incision in the peritoneum, for a hematoma will form and will cause subsequent trouble. In such a case the gauze drain should be introduced into the bed of the tumor, perhaps after partial closure of the peritoneal incision. Or if the bleeding be very profuse, the edges of the incision in the broad ligament should be sutured to the lower angle of the abdominal wound, and the cavity should be packed with gauze. The sutures that attach the broad ligament to the abdominal incision may be passed through the whole thickness of the abdominal wall, or through only the fascia, muscle, and peritoneum. The ends of the sutures should be left long to facilitate removal. In the removal of a cyst of the parovarium by enucleation, the tube and ovary should not be sacrificed unless they are diseased. Small cysts of the parovarium which develop between the layers of the mesosalpinx may very easily be removed by simple incision of the peritoneal capsule and enucleation of the cyst, without injury to the tube and ovary. =Marsupialization of the Cyst.=--In rare cases a cyst is found to be so firmly and generally adherent to surrounding structures that its removal is impossible. It is then necessary to practise marsupialization. The cyst should be evacuated with the trocar, which is introduced at a point which can be readily brought to the abdominal incision. Vegetations, etc. should be removed from the interior of the cyst with the fingers. The opening in the cyst should then be attached to the lower angle of the abdominal incision by interrupted sutures of strong silk that pass through the whole thickness of the abdominal wall and of the cyst-wall. The sutures should be placed close together, and the ends should be left long to facilitate removal. The upper portion of the abdominal incision should be closed with interrupted sutures. A large double drainage-tube of rubber should be introduced into the cyst, and strips of gauze should be packed around the tube. The subsequent treatment consists of frequent washing of the interior of the cyst. The sutures in the cyst-wall should be removed at the end of two weeks. Though marsupialization frequently results in cure, yet it should never be practised unless it is absolutely necessary. It exposes the patient to the dangers of prolonged suppuration and persistent fistula. Malignant degeneration has occurred in the wound. Papilloma may extend to the peritoneum. The procedure is of but little use in the case of multilocular tumors, as all the loculi cannot be evacuated. OPERATION FOR REMOVAL OF THE UTERUS. The uterus may be removed through an abdominal incision (abdominal hysterectomy), or it may be removed through the vagina (vaginal hysterectomy). A combination of the two methods of operating is sometimes employed.