Panendoscopy at the beginning of the operation. This shows a tumor island in the area of the arytenoid hump on the left side. Otherwise, a main tumor mass can be seen in the area of the pocket crease on the right side, which completely occupies it and also extends from here towards the morgue sinus. From here, the tumor extends into the area of the anterior commissure and appears to cross it at the median line. The glottic plane itself appears to be tumor-free. The panendoscopy is then completed with otherwise unremarkable mirror conditions. After repositioning the patient, inject local anesthetic with adrenaline pretracheally. Then transverse incision above the trachea and preparation in depth. Locate the prelaryngeal muscles, which are cut in the median plane. Further preliminary preparation in depth and exploration of the thyroid isthmus. As this is only very small, it is only coagulated extensively and then cut. Exposure of the anterior surface of the trachea. Now open the trachea between the 2nd and 3rd cartilage clasp. Preparation of a Björk flap. Then circular suturing of the tracheostoma and insertion of a size 7 tracheostomy tube after extubation of the patient. The patient is then repositioned for the TORS procedure. Insert the LARS blocker for this. Exposure of the epiglottis. Then perform an epiglottectomy from the base of the tongue. The incision is made with the monopolar over the plica pharyngoepiglottica backwards to the arya. Here, horizontal placement above the ary, taking along the tumor island located on the median surface. From here, resect endolaryngeally down to the pocket fold level. Here, the tumor is then deposited on the upper edge of the morgue sinus. The dissection is then continued ventrally. Then vertically split the epiglottis and initially remove the left part of the tumor up to the anterior commissure. The hemiepiglottectomy is then performed on the right side. Preservation of the pharyngoepiglottic plica. The entire ary appears not to be covered by the tumor. Therefore, only resection of the entire pocket fold up to the lower edge of the morgue sinus, the upper part of which also appears to be infiltrated by the tumor. From here, resection into the anterior commissure, where the tumor can be removed. The tumor is then resected in the area of the anterior commissure. This specimen is sent separately for histopathological examination. Now take marginal samples from the anterior commissure on the ary on the left side. The separate samples of the anterior commissure and the arytenoid region on the left are sent for frozen section diagnostics. The samples are found to be tumor-free by the pathologist. Therefore, after careful bleeding control, no further measures are taken. A nasogastric feeding tube is then inserted and the procedure is completed after removal of the Lars blocker. Initially nutrition via the nasogastric tube for the next 5 days. Then slowly build up oral nutrition depending on the tendency to aspirate. In a second session, neck dissection must be planned on both sides in 2-3 weeks. If the feeding is successful without aspiration, the tracheostoma can be closed during this session if necessary.