Preparation and intubation by anesthesia colleagues. First positioning of the patient, preliminary consultation with the anesthesia colleagues. First perform a pharyngo-laryngoscopy. This involves entering with the Kleinsasser tube under dental protection. The tumorous process is seen in the endolaryngeal region, particularly anteriorly located with infiltration of both vocal folds and clear growth towards the laryngeal skeleton. Therefore, in conjunction with the CT diagnosis, confirmation of the indication for laryngectomy. No evidence of infiltration of the supraglottic structures and extension towards the hypopharynx. Here, all mucosa is unremarkable and tumor-free. A nasogastric feeding tube was then inserted under pharyngoscopic control. Injection of xylocaine with added adrenaline. Dissection of an apron flap. Exposure of both sides of the sternocleidomastoid muscle, the submandibular gland and the digastric muscle. Due to the course, the facial vein is removed in good time. Neck dissection performed first. Start with the left side. Here, after exposure of the omohyoid muscle, free preparation of the internal jugular vein, exposure of the vagus nerve, common carotid artery, clearing of the anterior neck preparation while carefully protecting the cervical anus, the hypoglossal nerve and the superior thyroid artery. Exposure of the accessorius nerve and en bloc removal of the neck preparation. All exposed nerve structures are returned to their tissue bed after release. Exactly the same procedure on the opposite side. Here too, the accessorius nerve, vagus nerve and hypoglossal nerve are exposed. Subsequent neurolysis and re-embedding of the structures. Free preparation of the internal jugular vein and, together with level VI, removal of the neck preparation en block. Skeletonization of the laryngeal skeleton and release on both sides of the piriform sinus, release of the hyoid. This is followed by the trachatomy. This is done between the cricoid cartilage and the first tracheal ring. The thyroid isthmus is severed for this purpose. Successive release of the left thyroid lobe, which was clearly conspicuous due to nodules measuring up to 2 cm. This can be correlated well with the sonographic findings intraoperatively. Visualization of the recurrent nerve. Ligation of the thyroid gland close to the capsule. Ligation of the superior and inferior thyroid artery and the middle thyroid vein. The tumor is then resected. This involves entering the center of the vallecula, looping the epiglottis and successively widening the pharyngeal access. Mucosa-sparing resection and release of the laryngeal skeleton and removal of the laryngeal skeleton below the cricoid cartilage. Careful inspection. The glottic laryngeal carcinoma is exclusively endolaryngeal. This results in a safe in sano resection. The Provox prosthesis is then placed using the usual pull-through method. This is successful without any problems. Insertion of a 6 mm prosthesis. The paramedian myotomy is then performed in the area of the upper esophageal sphincter. Later, the sternal attachments of the sternocleidomastoid muscle are cut on both sides. The pharyngeal suture is then performed inverted and in multiple layers. Subsequently, insertion of a 10-gauge redon drain in each case. Careful two-layer wound closure and suturing of the tracheostoma. Subsequent problem-free transfer to a size 10 low-cuff cannula and completion of the procedure without any indication of complications.