Initially anesthesia induction and transoral endotracheal intubation using a laser tube by the anesthesia colleagues. A laryngo- and pharyngoscopy was performed using a Kleinsasser C-tube. This revealed an exophytic mass starting from the right lateral edge of the epiglottis, affecting the anterior half of the left aryepiglottic fold and extending into the upper 2/3 of the medial wall of the right piriform sinus; the anterior wall and lateral wall of the piriform sinus were not affected by the tumor. With extralaryngeal spread towards the hypopharynx V.a. cT2 supraglottic laryngeal carcinoma. A flexible esophagoscopy is then performed using a flexible endoscope, which is carefully advanced to the stomach with constant insufflation. The esophagus and the entire stomach up to the pylorus are normal. In the same session, a PEG tube is inserted in the typical manner using the thread pull-through method. This works well. Subsequent adjustment of the endolarynx and hypopharynx on the left using a Kleinsasser tube, somewhat more difficult to adjust in the case of a deep larynx, but transoral tumor resection still possible. Setting the laser to continuous mode at 6 watts and successive bypassing of the tumor starting in the middle of the epiglottis, first resecting the lingual epiglottis surface and then the laryngeal epiglottis surface. Inclusion of the left pharyngoepiglottic fold, bypassing the anterior 2/3 of the left aryepiglottic fold. As part of the resection, exposure of the vocal process of the left arytenoid cartilage, continuation of the tumor resection towards the medial wall of the piriform sinus using a "piecemeal" technique. A post-resection was performed in the aryepiglottic fold and a post-resection in the area of the medial wall of the right piriform sinus and then 5 marginal samples were taken (left resection margin, pharyngoepiglottic fold, aryepiglottic fold of the vocal process, medial wall of the piriform sinus, right ary). The intraoperative frozen section examination revealed positive findings in the marginal specimen of the medial wall of the piriform sinus and in the marginal specimen of the right arytenoid sinus. Therefore, <CLINICIAN_NAME> was consulted for resection in this region. A generous resection was performed in the area of the medial wall of the right piriform sinus and 3 marginal samples were taken (right arytenoid fold, right arytenoid region, basal arytenoid fold). The second intraoperative frozen section examination revealed negative findings in all marginal samples. Therefore, the clinical endoscopic diagnosis was R0. The patient was then repositioned to perform a neck dissection, initially on the right side. Skin spray disinfection. Infiltration anesthesia along the anterior border of the sternocleidomastoid muscle. Abjoration of the skin and sterile draping. Creation of an incision along the anterior border of the sternocleidomastoid muscle. Cut through the subcutaneous tissue and the platysma. Exposure of the anterior border of the sternocleidomastoid muscle. Exposure of the accessorius nerve, exposure of the digaster muscle as the upper limit of the dissection. Exposure of the omohyoid muscle as the lower limit of the preparation. Exposure of the internal jugular vein and then the entire cervical vascular sheath. Exposure and removal of the capsule of the submandibular gland. Exposure of the facial vein. Several enlarged lymph nodes in the area of the upper venous angle on the right which may correspond to a cN2b situation. Successive removal of the posterior neck specimen while sparing the plexus branches. Exposure of the hypoglossal nerve, successive dissection and removal of the anterior neck specimen. Hemostasis using bipolar coagulation. Wound irrigation using hydrogen peroxide and Ringer's solution. Insertion of a 10-gauge Redon drain. Two-layer wound closure. Application of a pressure dressing and repositioning of the patient to perform a modified radical neck dissection on the left side. Creation of a skin incision on the anterior edge of the sternocleidomastoid muscle. Identical to the opposite side. Separation of the subcutaneous tissue and the platysma. Exposure of the anterior border of the sternocleidomastoid muscle, exposure of the accessorius nerve, exposure of the digaster muscle, the omohyoid muscle, the cervical vascular sheath. Successive evacuation and removal of the posterior neck preparation while sparing the plexus branches. Exposure of the hypoglossal nerve in the area of the upper venous angle, as well as enlarged lymph nodes. Dissection revealed a very thin internal jugular vein on the left, which could be easily dissected from the neck preparation. Successive evacuation and removal of the anterior neck specimen. Hemostasis by means of bipolar coagulation, application of a 10-gauge Redon drainage, two-layer wound closure. Application of a pressure dressing. Due to the relatively large wound area in the area of the right supraglottis and right hypopharynx and the expected dysphagia, decision to perform a tracheostomy. Creation of a skin disinfection approx. 2 cm at the level of the caudal edge of the cricoid cartilage. Cut through the subcutaneous tissue, expose and push aside the prelaryngeal musculature. Exposure of the anterior wall of the thyroid isthmus, undermining it. Separation and ligation of both thyroid stumps. Exposure of the anterior wall of the trachea. Creation of an incision between the 2nd and 3rd tracheal cartilage clasp. Creation of a Björk flap and tracheostoma suture, skin suture. Creation of an epithelialized tracheostoma. Re-intubation into an 8 mm Rügheimer cannula and completion of the procedure without complications. Conclusion: This was a transoral, microlaryngoscopically controlled laser resection of a cT2 cN2b supraglottic laryngeal carcinoma on the right. The intraoperative frozen section examination revealed an R0 situation. Further procedure in our interdisciplinary tumor conference after receipt of the final histology. Cervical suture removal in 8 days, on the tracheostoma in 10 days, X-ray in 7 days recommended.