Anesthesia induction by the anesthesia colleagues and positioning of the patient by the surgeon. A tracheoscopy is performed using O° optics, with normal conditions in the trachea to carina area. The surgeon then performs endotracheal intubation and positions the patient. Laryngoscopy was performed using a Kleinsasser C-tube. This revealed a tumorous mass infiltrating the left hemilarynx from the left arytenoid cartilage to the anterior commissure and clearly growing in the paraglottic space. This makes it a better contraindication to complete laryngectomy and neck dissection on both sides. Application of local anesthesia cervically on both sides and medially. Skin ablation and sterile draping. Creation of a subplatysmal apron flap in the typical manner. Exposure of the cricoid cartilage and the thyroid cartilage isthmus. Undermining of the same. Exposure of the anterior tracheal wall and incision between the 3rd and 4th tracheal cartilage clasp. Fixation of the caudal tracheal margin to the skin edge. Retubation onto a size 8 laryngectomy tube, followed by dissection along the anterior border of the sternocleidomastoid muscle on the right side. Exposure of the capsule of the submandibular gland. Exposure of the accessorius nerve and the digaster muscle (posterior vein). Exposure of the omohyoid muscle and exposure of the cervical vascular sheath from caudal to cranial. Successive dissection along the cervical vascular sheath while sparing it and the plexus branches. Removal of the posterior and anterior neck specimen while protecting the above-mentioned structures. Hemostasis there using bipolar coagulation. The patient is then repositioned and a neck dissection is performed on the left side. Dissection along the anterior border of the sternocleidomastoid muscle on the left side. Exposure of the accessorius nerve in depth. Exposure of the posterior venter of the digaster muscle. Exposure of the omohyoid muscle. Exposure of the cervical vascular sheath. Dissection along the internal jugular vein from caudal to cranial. Successive removal of the posterior and anterior neck preparation while protecting the above-mentioned structures and the plexus branches. Hemostasis there using bipolar coagulation. A total laryngectomy is then performed. Dissection of the prelaryngeal muscles in the midline. Transverse incision of the prelaryngeal musculature at the level of the hyoid bone using a monopolar knife. Median pharyngotomy. Exposure of the epiglottis after transection of the hyoepiglottic ligament. Exposure of the free edge of the epiglottis. The pharyngeal lumen is then opened and the epiglottis is pulled downwards with the hyoid bone. Then scalpel incision along the posterior edge of the thyroid cartilage on both sides, subperichondral preparation and protection of the piriform sinus on both sides. Subsequent mucosal incision along the free epiglottis edges and the aryepiglottic folds on both sides. Joining of both vertical mucosal incisions in the postcricoid area. Submucosal dissection with protection of the mucosa and the submucosa of the anterior esophageal wall between the trachea and esophagus. Dissection to this level caudally and placement of the laryngectomy specimen between the 2nd and 3rd tracheal cartilage clasp. Two margin samples (anterior tracheal resection margin, posterior tracheal resection margin) were taken, which were sent for frozen section and both were found to be tumor-free by the pathology colleague. Subsequently, paramedian myotomy of the cricopharyngeal muscle on the left side and partial resection of the caudal part of the sternocleidomastoid muscle on both sides. Subsequent retrograde placement of a size 10 Provox Vega without any problems. Four-layer pharyngeal suture (mucosan, submucosa, pharyngeal muscle layer, infrahyoid muscles), resulting in complete pharyngeal closure. To secure the pharyngeal suture, several cut pieces of Tachosil were inserted along the entire T-shaped pharyngeal suture. Hemostasis using bipolar coagulation. Dry conditions. Knock back the subplatysmal apron flap and fix its caudal edge to the tracheostoma. Platysma suture, single button skin suture. Application of a pressure bandage, completion of the procedure without complications. Please feed the patient via the inserted nasogastric tube for the next 10 days, then perform an X-ray pre-swallow. The patient received Unacid 3 g intravenously as a single shot intraoperatively.