The tumor can be seen consuming the entire uvula and extending along the anterior soft palate on the left side to the left posterior palatal arch on the left side. For G3 differentiation, a distance of 1 cm is measured and the resection margin is marked. Successive removal of the tumor from <CLINICIAN_NAME> and <CLINICIAN_NAME> alternately. The left tonsil is also removed here. After successive removal, the specimen is marked under inspection and palpation. Successive hemostasis. A resection is taken on the right parauvular side. Everything goes to the frozen section. The frozen section shows an R0 resection. Tracheotomy: skin incision, dissection through the subcutaneous fatty tissue. Dissection along the linea alba through the prelaryngeal musculature. Finding the cricoid cartilage. Careful coagulation of the thyroid gland and dissection of the thyroid gland. Free preparation of the trachea. Visor tracheotomy between the 2nd and 3rd tracheal clasp. Suturing in the usual manner. Neck dissection on the right side: skin incision and dissection through the subcutaneous fatty tissue. Exposure of the anterior border of the sternocleidomastoid muscle. Dissection in depth. Exposure and protection of the accessorius nerve. Exposure of the omohyoid muscle and cranial dissection. Exposure of the submandibular gland and finding the posterior venter of the digastric muscle. Exposure of the digastric muscle and successive dissection of this up to region II b. Multiple suspicious metastases are found in region II b, also in the jugulofacial angle. Dissection of the internal jugular vein and visualization of the same. It can be seen that the large metastasis in the jugulofacial angle is connected to the facial vein. For this reason, ligation of the facial vein and removal of the metastasis. The hypoglossal nerve can be identified and spared. Successive dissection of the other suspicious masses, sparing the internal jugular vein. Successive dissection of the lateral neck preparation while sparing the brachial plexus. Identification and protection of the vagus nerve. The cervical nerve can also be spared. Removal of the lateral neck preparation. Successive removal of the medial neck preparation. Irrigation and successive hemostasis. If there is no evidence of increased bleeding, insertion of a Redon drain. Two-layer wound closure. Lifting of the radial artery flap by <CLINICIAN_NAME> and <CLINICIAN_NAME>: marking of the radial artery. Palpatory identification of the distal radial artery. Marking of the flap borders 4 x 6 cm on the distal forearm proximal to the flexor retinaculum, with an S-shaped course. Cut proximally into the cubital fossa. Incision of cutaneous and subcutaneous tissue from proximal. Identification. Exposure of the venous confluence in the cubital fossa. Identification of the cephalic vein and dissection of the vein distally with integration into the graft margin. It can be seen that the cephalic vein is pulling towards the skin, away from the planned skin island. The vein is therefore severed here. Identification of the external ramus of the radial nerve. Elevation of the radial part while leaving the fascia of the tendon of the brachioradialis muscle intact. Subsequent dissection down to the forearm fascia. Incision of the fascia and subsequent subfascial elevation of the forearm graft edge up to the tendon of the flexor carpi radialis muscle. Care is taken to leave the peritendinous tissue on the flexor tendon and to spare the ulnar artery. Identification of the distal radial artery and trial clamping with a vascular clamp. After 5 minutes under good oxygen saturation measured by pulse oximetry, measured on the thumb, approx. 99%, the vessels are removed with subsequent ligation with silk thread. Successive detachment of the flap pedicle from the M. pronator quadratus and M. flexor pollicis longus with ligation of the outgoing perforators using a vessel clip into the cubital fossa. Exposure and sparing of the radial nerve on the medial side of the brachioradialis muscle. Exposure of the brachial artery and the mediana cubita, the ulnar artery. First of all, expose the radial artery. Then of two veins of the superficial venous system, vascular ligation using silk thread and vascular clips. Subtle hemostasis in the area of the wound bed using bipolar coagulation forceps. Two-layer wound closure in the area of the proximal forearm. Defect coverage of the graft bed with split skin from the right thigh in the usual manner. Application of a wound dressing and forearm splint. Completion of graft elevation without complications. ND left skin incision and dissection through the subcutaneous fatty tissue. Exposure of the anterior border of the sternocleidomastoid muscle. Dissection in depth. Exposure and protection of the accessorius nerve. Exposure of the omohyoid muscle and cranial dissection. Exposure of the submandibular gland and finding the posterior venter of the digastric muscle. Exposure of the digastric muscle and successive dissection of this up to region II b. Dissection of the internal jugular vein and exposure of the same. Ligation of the facial vein and removal of the metastasis. The hypoglossal nerve can be identified and spared. Successive dissection of the lateral neck preparation while sparing the brachial plexus. Identification and protection of the vagus nerve. The cervical nerve can also be spared. Removal of the lateral neck preparation. Successive removal of the medial neck preparation. Dissection of the superior thyroid artery as a connecting vessel. After removal of the submandibular gland on the left side while protecting the lingual nerve, an orotracheal fistula is created to pull the flap through. This is pulled through and attached to the defect. The posterior part of the flap is sutured to the posterior palatal arch, the anterior part of the flap to the anterior palatal arch and the lateral part within the tonsillar ligament. This is done with 4-0 single button Vicryl sutures. Performing the anastomosis in the sense of an arterial anastomosis between the radial artery and the superior thyroid artery on the left side as well as two end-to-side anastomoses to the internal jugular vein. Insertion of a flap and a Redon drainage. Fixation of the pedicle with Vicryl sutures to prevent twisting of the pedicle. Two-layer wound closure.