Figure 2: Preparation of the external jugular vein. The right external jugular vein was dissected free and mobilized as far as possible. All of the small branches of the external jugular vein were cut with fine-tip cautery. The proximal portion of the external jugular vein was occluded with microhemostat clamps, and the external portions of the external jugular vein were ligated with 6-0 silk. Then, a small hole was made at the bifurcation with fine scissors (a). The external vein was passed through the 22-gauge cuff with super-fine-tip forceps. On pulling the divided veins with superfine-tip forceps, the proximal end of the jugular vein was everted over the cuff (b,c) and fixed to it by a circumferential ligature of 7-0 silk (d).