Introductory consultation with the anesthetist. Injection of local anesthetic with adrenaline. Zigzag skin incision prelaryngeal and preparation in depth. Separation of the platysma. Further dissection in depth on the prelaryngeal muscles. This is separated in the midline. Expose the upper edge of the thyroid cartilage and the lower edge of the cricoid cartilage. Remove all soft tissue above the larynx. A clearly enlarged prelaryngeal lymph node can be seen. This is removed separately and sent for frozen section diagnostics. The lymph node is found to be tumor-free intraoperatively. After visualization of the laryngeal skeleton, incision of the periosteum and pushing the periosteum laterally. Transverse incision of the ligamentum conicum and subsequent passage of the thyrofissure in the midline. The larynx is opened in the anterior commissure. The left side looks completely unremarkable. Removal of a marginal sample from the left anterior commissure. On the right side, the exophytic tumor is visible, which completely occupies the vocal fold and partially infiltrates the morgue sinus. However, the tumor has certainly not reached the folds of the vocal fold. The tumor is now dissected subperichondrally starting at the anterior commissure. The perichondrium is pushed away from the thyroid cartilage. Dissection is carried out from ventral to dorsal with a safety distance of about 3 mm from the subglottic slope to the tumor. Also maintain a safe distance in the direction of the morgnoid sinus. The tumor reaches close to the vocal process, but certainly does not infiltrate the posterior commissure. Dissection is now performed on the anterior surface of the arytenoid cartilage. Exposure of the vocal process. The tumor can then be deposited dorsally with a tiny portion of the vocal process at a safety distance of about 2 mm. Inspection of the specimen. This is then thread-marinated. A fringe of healthy tissue can be seen all around the tumor. The specimen is sent to the frozen section marked with a thread. All the margins are marked as tumor-free. The safety margin towards the perichondrium is sometimes less than 1 mm. For this reason, a piece of perichondrium in the dorsal section of the resection area is removed again and sent separately for final histological assessment and confirmation of the R0 situation. Perform subtle hemostasis. Mobilization of the pocket fold on the right side. For this purpose, an incision is made above the pocket fold at approximately the level of the upper edge of the thyroid cartilage. Complete mobilization of the entire pocket fold caudally, which is now sutured to the subglottic slope. The anterior commissure on the left side and the newly formed caudally displaced pocket fold are also sutured ventrally. Closure of the thyrofissure and closure of the ligamentum conicum with single button sutures. Closure of the prelaryngeal musculature. Two-layer wound closure after insertion of a wound flap. Application of a pressure dressing. Final consultation with the anesthetist. Completion of the procedure.