Induction of anesthesia and nasal intubation by the anesthetist. First, pharyngoscopy and inspection of the glottic plane. This reveals an exophytic mass in the right anterior commissure with transition to the left third of the vocal folds and extension to the pocket folds. Inspection of the piriform sinus on both sides. No tumorous mass on either side. Insertion of a nasogastric tube and insertion with the flexible endoscope and endoscopy up to the stomach. Inspection of the stomach. Inconspicuous conditions on all sides. Perform PEG insertion (<CLINICIAN_NAME>, <CLINICIAN_NAME>) using the thread pull-through method. Repositioning for laryngectomy and neck dissection. Creation of an apron flap with subplatysmal dissection in the typical manner up to the level of the hyoid bone. The skin and platysma flap is then folded upwards and fixed with holding sutures. Start of neck dissection on the right side through <CLINICIAN_NAME>. Exposure of the sternocleidomastoid muscle, the omohyoid muscle and the submandibular gland. Then visualization of the digastric muscle. Finding the accessorius nerve and the cervical vascular sheath. Then free preparation of the internal jugular vein. Visualization of the vagus nerve, the internal and external carotid artery, the accessorius nerve and the hypoglossal nerve. Then release of the neck preparation in levels II to V while sparing the cervical plexus branches. Free preparation of the facial vein and release of the medial part of the neck. Transition to the opposite side and neck dissection on the left side. In principle the same procedure as on the right. Exposure of the sternocleidomastoid and omohyoid muscles. Exposure of the submandibular gland and also exposure of the digastric muscle. Exposure of the accessor nerve and exposure of the cervical vascular sheath. Visualization of the internal jugular vein, internal and external carotid artery, vagus nerve and hypoglossal nerve. Then release of neck levels II to V while sparing the branches of the cervical plexus and the accessorius nerve. Exposure of the facial vein and release of the medial part of the neck. Transition to laryngectomy. First dissection of the infrahyoid muscles on the hyoid bone. Exposure of the upper horn of the thyroid cartilage and dissection of the prelaryngeal musculature. Exposure of the thyroid gland. Dissection and ligation of the thyroid isthmus. Exposure of the anterior wall of the trachea. This is very difficult because the patient has already undergone a biopsy in this area. Some lymph nodes are still visible here, which are sent in for histology. Entering the trachea between the 1st and 2nd tracheal cartilage. Creation of a mucocutaneous anastomosis and reintubation onto a laryngectomy tube. Further skeletonization of the larynx and detachment of the piriform sinus and the pharyngeal tube from the larynx. Creation of a pharyngotomy at the upper edge of the larynx. Extraction of the epiglottis and removal of the larynx with further opening of the pharyngeal tube. The larynx is removed from the trachea below the cricoid cartilage. Inspection of the pharyngeal tube and the esophagus. Now <CLINICIAN_NAME> performs the myotomy on the esophagus. Here in the anterior position. Then call <CLINICIAN_NAME> and intraoperative demonstration of the placement of a Provox 80 prosthesis in a typical manner. Then transition to pharyngeal suture. This is performed in a typical multi-layered manner. First, single button sutures on the mucosa so that the mucosa can be adapted inverted. Then a second inverting suture over the pharyngeal tube using single button sutures. Suture the pharyngeal constrictor muscle so that the pharyngeal tube is well sealed from cranial to caudal. Once again careful hemostasis using bipolar coagulation. Insertion of two Redon drains. Completion of the mucocutaneous anastomosis to create a tracheostoma. Two-layer wound closure. Insertion of a 10 mm tracheostomy tube. Sterile wound dressing and completion of the operation without complications.