Introductory consultation with the anesthesia department. Positioning of the patient. Abjoration of the skin, injection of local anesthetic without adrenaline. Ellipsoidal vertical skin incision prelaryngeal with resection of the old tracheotomy scar. Layered preparation in depth. Exposure of the prelaryngeal musculature. This is cut in the midline and dissected to the side. Exposure of the laryngeal skeleton. Further exposure of the ligamentum conicum. This is incised after saturation of the patient and the incision is extended laterally. Dissect the perichondrium from the laryngeal cartilage. This is opened in the median line with the wheel. Insertion of the retractor. Opening of the epithelium endolaryngeally. The tumor described above can be seen on the left side. A marginal sample is taken in the area of the anterior commissure. The tumor does not appear to cross the midline here. Dissection from ventral to the thyroid cartilage. Strict dissection of the thyroid cartilage. The tumor extends slightly subglottically and infiltrates the cranial pocket fold. Dorsally, the tumor extends to the arytenoid cartilage. The patient should therefore be intubated via the laryngofissure. The endolaryngeal tube is thread-armed and remains cranially in the area of the supraglottis. The resection is initially performed at the caudal edge of the sedimentation, slightly subglottic, from ventral to dorsal. Furthermore, resection of the tumor in the cranial deposition area with removal of the caudal part of the pouch ligament on the left side. In the dorsal area, the arytenoid cartilage is largely skeletonized and the resection is completed by removing the vocal process. The tumor specimen is sent for definitive histopathological assessment. Further frozen sections are taken from the caudal and cranial margins of the arytenoid process. Furthermore, removal of a marginal sample from the cranial edge of the deposit in the area of the pocket crease. Removal of marginal samples from the wound bed and removal of a subglottic marginal sample from the caudal margin. All marginal samples are sent for frozen section diagnostics and are diagnosed as tumor-free by the pathologist. Careful hemostasis is then performed. Suturing of a laryngeal wedge and closure of the laryngofissure after making a total of four drill holes. Suturing of the ligamentum conicum. Mobilization of soft tissue, which is closed prelaryngeally with single button sutures. Insertion of a wound flap. Repeated dissection of prelaryngeal fatty tissue. This is also sutured using single button sutures. Two-layer skin closure. Application of a pressure bandage. Final consultation with the anesthetist. Completion of the procedure. The patient is transferred to the in-house intensive care unit for monitoring.