Abstract
The indications for total hysterectomy are definite and have been emphasized. Cautery of the cervix and repair of cervical lacerations are not considered desirable if total hysterectomy can be safely performed. The mortality of total hysterectomy is less than the incident of cervical stump cancer in properly selected cases under competent hands. None of the serious objections often mentioned are encountered when the vaginal vault is well supported and length maintained. The right angle clamp below the cervix, across the vagina as an aseptic precaution seems inadvisable. It shortens the vagina. It is better to open the vagina and reconstruct the vault under direct vision, building up a firm support by the uterosacral ligaments, vaginal fascia and round ligaments.
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