Background: A successful anastomosis is the Achilles of all microsurgeries. Prevention of turbulence at anastomotic site is vital and ensure blood flow to be maintained.

Aim: To share our experience based on a simple method for dealing with cases of vascular discrepancy by maintaining proper intravascular flow.

Methods: Of the 110 patients undergoing surgery, a total of 240 vascular anastomoses were performed in the arteries and veins. Of these, anastomosis occurred in 10 cases with discrepancy between recipient and donor vessels.

Results: The result showed no partial or total flap necrosis occurred in these patients. In all cases we confirm anastomosis patency with portable intra-op Doppler device. In these cases, we did not have any venous congestion or any sign of blood stream compromising in flap circulation.

Conclusion: Using introduced technique is easy and feasible in advanced head and neck reconstruction. Performing this technique needs less experienced surgeon thus helping reducing total surgery time in advanced stage, post radiotherapy recurrence and morbid patients.

Keywords: Anastomosis, Head and Neck, Reconstruction, Free flap, Tumor.