After induction of anesthesia by the anesthesia colleagues, first nasotracheal intubation by the anesthesia colleagues. Now intubation with the small bore tube. Inspection of the hypopharynx on both sides, the endolarynx, the epiglottis and the vallecula. Inconspicuous mucosal conditions everywhere. Now enter with the esophagoscope under constant air insufflation into the stomach. Inversion. Inconspicuous mucosal conditions here. Subtle redness. After a positive diaphanoscopy, a PEG tube was inserted without any problems using the thread pull-through method. Now insertion of the thread-reinforced mouth guard. Tightening of the tongue. The tumor described above can be seen in the area of the left edge of the tongue with a central ulcer. This lump is now carefully surrounded with the electric needle, bipolar coagulation and the pointed scissors and successively removed. This creates a relatively large defect in the area of the left tongue. Finally, the tumor can be removed macroscopically on all sides far into the healthy tissue. The tumor is thread-marked for frozen section diagnostics. This reveals tumor cell extensions in the area of the anterior specimen and cranially. A large resection is therefore taken from this area. This specimen is sent for urgent histology. Subsequently, marginal samples are taken and sent for frozen section diagnostics, where they are declared tumor-free. An R0 resection can therefore be assumed. Careful hemostasis with bipolar forceps. The result is a relatively large defect in the area of the left edge of the tongue and the floor of the mouth. Further procedure depending on the healing process. Now turn to neck dissection on both sides. Sterile wiping and covering. Infiltration anesthesia with 10 ml xylocaine with adrenaline in each case in the area of the sternocleidomastoid anterior edge. Start on the right side. Dissection through the subcutaneous tissue. Exposure of the platysma. Creation of a small platysma flap. Exposure of the sternocleidomastoid and its anterior edge. Exposure and sparing of the accessorius nerve. Exposure of the omohyoid muscle and the digastric muscle. Exposure of the internal jugular vein and the cervical vascular sheath with carotid and vagus nerve. Protect these structures. Careful dissection along the jugular vein and removal of the posterior neck specimen. This works very well. Now remove the anterior neck specimen with the glandular capsule. No further conspicuous nodules can be seen. All important vessels, such as the jugular vein or superior thyroid vein, can be spared. Now turn to the left side. Skin incision here too. Dissection through the subcutaneous tissue and the platysma. Creation of a platysmal flap. Expose the anterior edge of the sternocleidomastoid. Dissection on the accessorius nerve. Exposure of the digastric muscle and the omohyoid muscle. Dissection along these muscles. Exposure of the submandibular gland. Removal of the capsule. Careful removal of the lateral neck preparation while protecting the plexus branches. This is very successful. Several nodes can be palpated here, all of which are removed. Careful dissection in the area of the anterior neck preparation and removal of the soft tissue here too. Careful bipolar hemostasis. Exposure and sparing of the hypoglossal muscle on both sides. Bipolar hemostasis. Irrigation of the neck wound area on both sides with H2O2 and Ringer's solution. Insertion of a Redon drain. Two-layer wound closure. Application of a pressure bandage. Completion of the procedure without complications. Further procedure after receipt of the final histology. The patient received 3 g Unacid once intraoperatively. Conclusion: Overall enoral resection of a cT2 tongue margin carcinoma on the left. Based on the frozen section diagnosis, an R0 situation can be assumed. Further procedure after receipt of the final histology and function.