After active patient identification, the patient is brought into the operating theater. Carry out the team time-out. Introductory consultation with the anesthesia colleagues. Induction of anesthesia and transition to rigid tracheoscopy. Problem-free passage of the glottis and endotracheal entry. The mucosal conditions are inconspicuous on all sides up to the exit of the segmental bronchi. The endoscope is then removed and the patient intubated by the surgeon. Transition to esophagogastroscopy. Insertion of the endoscope under visualization and constant air insufflation into the stomach. A slightly erosively altered gastric mucosal relief can be seen here. Inspection of the corpus fundus antrum and pylorus. Entering the inversion. Inspection of the gastroesophageal junction. Here refluxy change. Desufflation slow withdrawal of the endoscope with circular inspection of all esophageal sections. There is no evidence of a synchronous second tumor. Remove the endoscope and position the patient in head reclination. Insert a compress to protect the alveolar ridge. Enter with the size C small bore tube. First, adjust the endolarynx. This is unremarkable. Then inspect the hypopharynx, the postcricoid region and the esophageal entrance. The mucosal conditions are unremarkable on all sides. The same applies to the base of the tongue. The supraglottic region as well as the oral cavity and oral vestibule. Only in the area of the left tonsil is there a superficially growing, circumscribed exophytic change extending from the middle to the caudal left tonsil pole. The borders of the tonsil are respected both by inspection and palpation. In summary, CT1- maximum CT2 tonsillar carcinoma on the left is suspected. Since the tumor is strictly limited to the tonsil, the decision is now made to perform an excision biopsy in the sense of a tumor tonsillectomy. To do this, first grasp the tonsil and medialize it. Incision of the mucosa close to the uvula, exposing the tonsil capsule. Successive dissection along the capsule in the area of the cranial part. In the middle and caudal sections, part of the palatal arch muscles of the anterior and posterior palatal arch are also resected in order to ensure a sufficient safety margin. After caudal dissection into the base of the tongue. Macroscopically, the tumor was resected in toto. Suture marking of the tumor resectate and sending for frozen section diagnostics. Cis-like changes can still be seen in the area of the anterior palatal arch. The tumor is resected again and the resectate is sent in for frozen section diagnostics. R0 situation at the end of the operation. Hemostasis using bipolar coagulation. Dry wound conditions at the end of the operation. Final consultation with anesthesia colleagues. Removal of the mouth blocker and completion of the operation without complications. Conclusion: suspected CT1-2 tonsillar carcinoma on the left. Neck dissection on the left side and, if necessary, PEG insertion must now be planned in a two-stage procedure.