In many conditions it is not necessary to remove the cervix. Partial hysterectomy or supra-vaginal amputation of the uterus at some convenient point of the cervix may be performed. Such supra-vaginal amputation of the uterus may be done in nearly all operations that are not performed for malignant disease. In sarcoma or cancer the whole uterus should be removed at the vaginal junction, and, if necessary, the upper portion of the vagina should be excised. In the case of fibroid tumor and in non-malignant disease of the body of the uterus supra-vaginal amputation is sufficient. Supra-vaginal amputation is an easier and safer operation than complete hysterectomy. Abdominal hysterectomy is most easily performed with the patient in the Trendelenburg position. =Supra-vaginal Amputation of the Uterus.=--After the abdomen has been opened, the ovarian artery should be ligated in the infundibulo-pelvic ligament, as in the operation of salpingo-oöphorectomy. A second ligature, or forceps, should then be placed upon the ovarian artery at the uterine cornu. The round ligament should then be ligatured with medium-sized silk at a point situated about an inch from the uterus. Similar ligatures should then be placed about the ovarian artery and the round ligament on the opposite side. [Illustration: FIG. 213.--Supra-vaginal amputation of the uterus, first step: ligatures have been placed on the ovarian arteries and the round ligament.] The infundibulo-pelvic ligament immediately outside of the abdominal ostium of the tube, the round ligament between the ligature and the cornu, and the broad ligament as far as the uterus should then be divided with scissors on each side. The uterus is thus freed from all its attachments down to a point somewhat above the level of the internal os. The vessels that remain to be secured are the uterine arteries. The peritoneum is next divided by a transverse incision across the anterior face of the uterus, immediately below the line of reflection of the peritoneum from the uterus to the bladder. This incision should join at each end the incisions that had been previously made in dividing the broad ligaments. [Illustration: FIG. 214.--Supra-vaginal amputation of the uterus, second step: the broad ligaments have been divided down to the level of the internal os uteri.] The bladder should then be dissected from the anterior face of the uterus and cervix, down to the vaginal junction. The bladder is but loosely attached to the uterus, and may be readily pushed off with the finger or with closed scissors. The finger pressed out to a short distance on each side of the cervix will push away the anterior layer of the broad ligament with the bladder, so that the uterus is perfectly free in front.