Enter with 0° optics, then transnasal intubation. Tracheoscopy shows that the tumor extends far to the subglottic side and completely infiltrates the subglottic slope on both sides. Then enter with the small bore tube and inspect the tumor again as described above. Sterile washing and draping. Creation of an apron flap in the usual manner. Neck dissection on the left side. Exposure of the sternocleidomastoid muscle. Exposure of the omohyoid muscle. Exposure of the submandibular gland and the digastric muscle. Visualization of the accessorius and hypoglossus. Exposure of the cervical vascular sheath. Clearing of levels II a to V a while sparing the plexus branches. Turning to the opposite side. Exposure of the sternocleidomastoid muscle. Exposure of the omohyoid muscle. Exposure of the submandibular gland. Showing the accessorius and hypoglossus. Exposure of the cervical vascular sheath and clearing of the neck levels II a to V a while sparing the plexus branches. Release of the hyoid bone. Detachment of the oblique laryngeal muscles. Detachment of the thyroid gland. Exposure of the anterior wall of the trachea. Performing a tracheotomy between the 3rd and 4th tracheal cartilage. Release of the piriform sinus on both sides. Entering the pharynx from the right. Disluxation of the epiglottis. Detachment of the larynx from the pharyngeal mucosa. Separation of the larynx between the 3rd and 4th tracheal cartilage. Removal of marginal samples, 1x from the posterior and anterior tracheal wall and pharyngeal side wall on both sides. All edge samples in the frozen section completely free. Overall R0 situation in the frozen section. Then perform the esophageal myotomy on the left side. Insertion of a Provox-Vega prosthesis in the usual manner. Then start with the pharyngeal suture in three layers in the usual manner. Insertion of Redon drains and two-layer wound closure.