The vagus nerve will be identified in the carotid sheath in a posterior groove between the carotid artery and the jugular vein. Vessel loops will be used to mobilize the vagus nerve so that about 2.5 to 3 cm will be available for attachment of the spiral cuff. After, the nerve segment will be completely freed from its surrounding tissues and the cuff was then carefully attached to the exposed nerve. Since the need to "seal" the cuff on the nerve with a suture will be unnecessary, the cuff implantation was a relatively simple operation. Namely, the self-fitting nature of the spiral design made it easy to fit snug cuff on a nerve. Furthermore, the spiral cuff design was devised to induce very low pressure when installed on the nerve so that any passively-induced nerve damage will be eliminated. A special care however, will be taken to route the leads to the connector to avoid as much as possible a mechanical tension being transmitted to the cuff. Special care will be taken during surgery also to avoid of causing any mechanical trauma to the recurrent laryngeal nerve.