First induction of anesthesia and ventilation of the patient via the existing tracheostoma. Laryngoscopy was then performed using a Kleinsasser C-tube. Inspection of the endolarynx, revealing an exophytic mass originating from the right interaryngeal region and affecting the posterior 2/3 of both vocal folds without significant subglottic spread. Thus verification of the indication. Skin spray disinfection. No local anesthesia after consultation with anesthesia colleagues. Cervical skin ablation and sterile draping. Creation of a skin incision, lifting of a subplatysmal apron flap. Placement of bridle sutures. Exposure and ligation of the anterior jugular vein with its branches. Exposure of the anterior border of the sternocleidomastoid muscle on the right side. Exposure and sparing of the right external jugular vein. Exposure and sparing of the right auricularis magnus nerve. Exposure of the right accessorius nerve, the posterior venter of the digaster muscle. Exposure of the submandibular gland. Exposure of the omohyoid muscle. Exposure of the cervical vascular sheath. Successive evacuation of the posterior and anterior neck preparation while sparing the above-mentioned structures and the plexus branches. This results in a modified radical neck dissection of regions Ib to V on the right side. Identical procedure on the left side. Dissection along the anterior border of the sternocleidomastoid muscle. Exposure and sparing of the accessorius nerve of the posterior venter of the digaster muscle and the omohyoid muscle. Exposure of the cervical vascular sheath. In region III on the left side there is a highly visible mass which can be easily detached from the cervical vascular sheath. Successive removal of the posterior and anterior neck specimen while sparing the above-mentioned structures of the plexus branches. The specimen is removed caudally and the removal frame is repositioned. Hemostasis on both sides using bipolar coagulation and subsequent skeletonization of the hyoid bone, skeletonization of the thyroid cartilage at its posterior ..................................... on both sides. Strict care is taken to ensure that the dissection is performed subperichondrally on the inner surface of the thyroid cartilage, thus sparing the piriform sinus as much as possible on both sides. Dissection of the prelaryngeal muscles at the level of the hyoid bone. Subsequent exposure of the free epiglottis margin and median pharyngotomy. Dissection along the lateral edge of the epiglottis on both sides and the aryepiglottic folds on both sides. Maximum protection of the pharyngeal mucosa in the area of the piriform sinus on both sides, transverse mucosal incision postcricoidally. Joining the lateral incision with this transverse incision and entering the region between the posterior wall of the trachea and the anterior wall of the oesophagus. Dissection caudally in this layer. Repeated hemostasis using bipolar coagulation. Dissection of the thyroid gland from the side wall of the trachea on both sides, inspection of the specimen from the caudal side and easy removal of the specimen at the level of the already inserted tracheostoma. A tracheal cartilage clip is then resected and sent with the specimen for final histology. The anterior border samples are then taken: posterior edge of the tracheal sedimentation, postcricoid mucosa, medial wall of the right piriform sinus, medial wall of the left piriform sinus, base of the tongue. All marginal samples were found to be tumor-free by the pathology colleagues. Subsequently, cricopharyngeal myotomy in the typical manner. Subsequently, three-layer pharyngeal suture (thin submucosal connective tissue layer, transversely striated pharyngeal wall muscles, prelingual residual muscles). The pharyngeal suture is then reinforced using several cut pieces of Tachosil. Dry conditions. Placement of 2 Redon drains on both sides. Completion of the epithelialization of the tracheostoma at its cranial and lateral edges. Two-layer wound closure. Application of a pressure dressing. Completion of the procedure without complications. Conclusion: Complete laryngectomy, modified radical neck dissection on both sides in regions Ib to V, control of the pharyngeal suture by means of an X-ray and suture removal on the 10th postoperative day. Prompt presentation of the patient to our tumor board after receipt of the final histology for the purpose of planning further therapy.