First, the patient is positioned and another panendoscopy is performed to confirm the findings. The findings are essentially unchanged compared to the previous examination, with the tumor extending as described above. Otherwise no indication of a secondary tumor. Then insertion of the Olympus oral retractor and adjustment of the tonsil lodge. Then insertion and positioning of the robotic arms. Use a monopolar spatula and Maryland forceps. Then expose the tumor. With a sufficient safety margin, start the resection on the anterior soft palate parauvularly. The resection is then performed along the posterior molar to the base of the tongue via the glossotonsillar groove. As the tumor cannot be reliably separated from the base of the tongue here, a small part of the base of the tongue is resected. The tumor is then developed and a partial resection of the posterior palatal arch is performed. The dissection is performed in such a way that a soft tissue margin remains on the tonsil capsule. There is no evidence of tumor infiltration in the area of the lateral tonsil capsule. After complete removal, the specimen is then thread-marked and sent for histopathological assessment. In the area of the scarce resections at the glossotonsillar groove and at the base of the tongue, additional marginal samples are taken, which are assessed as tumor-free in the frozen section. After tumor removal, the most subtle hemostasis is performed. Then absolutely dry wound conditions. Then removal of the oral retractor and removal of the surgical instruments. The patient is then repositioned for neck dissection on both sides. Injection of local anesthetic with adrenaline on both sides of the neck. Then start the neck dissection on the left side via a skin incision along the front edge of the sternocleidomastoid muscle. Then layer-by-layer dissection in depth after cutting through the platysma, exposing the anterior edge of the muscle. Then expose the cervical vascular sheath. Now dissect along and expose the cervical vascular sheath. A large conglomerate of lymph nodes can be seen in the area of the venous angle. The lymph nodes also appear clinically conspicuous here. Then dissection of level Ib while preserving the branches of the external carotid artery and the internal jugular artery. The capsule of the submandibular gland is not removed during dissection. Subsequently, further dissection of levels II, III, IV and V. Numerous lymph nodes already extend caudally along the cervical vascular sheath, so that the dissection is also carried out far caudally. When the specimen is placed in the caudal section, an opening of the thoracic duct can be seen, with fluid leaking out here. This area is then sutured over with a small amount of sternocleidomastoid muscle and the entire region carefully stitched over. Even when the intrathoracic pressure was raised via a peep by the colleagues in the anesthesia department, there was no further leakage of chyle. Subsequent subtle hemostasis and insertion of a Redon drain. Then two-layer wound closure. Now move to the right side. Here too, skin incision along the sternocleidomastoid muscle. Then layer-by-layer dissection in depth. Cut through the platysma, then expose the anterior edge of the sternocleidomastoid muscle and the cervical vascular sheath. Subsequently, a clearly smaller conglomerate can be seen at the lymph node in the venous angle. Then evacuation of level Ib, sparing the branches of the external carotid artery and internal jugular artery. Level II and III were also removed. After no further suspicious nodes are found in the caudal region, which are also not described on CT, and the tumor is nowhere near the midline, no further clearing of levels IV and V is performed. Subtle hemostasis is then performed and a Redon drain is then inserted. Here too, subsequent two-layer wound closure. After bandaging, the procedure is completed and the patient is transferred to the recovery room after extubation.