First, the patient is taken to the operating theater and identified. Followed by a consultation with the anesthesia colleagues. Induction of anesthesia and intubation by the anesthesia colleague. Head positioning, insertion of the Mc Ivor mouth spatula, taking the teeth, lips and tongue into account. The tonsil tumor is now removed macroscopically with a safety margin of at least 1-1 1/2 cm to all sides. Suture marking of the tumor as a whole. In addition, a caudal and medial margin sample is taken. The frozen section shows a tumor that has been removed on all sides in healthy tissue. Only medially and caudally is the mucosa somewhat questionable, so a resection is taken here again. Careful hemostasis. Repositioning for neck dissection on the right:: Skin incision on the anterior border of the sternocleidomastoid muscle from mastoid to caudal at the level of the omohyoid muscle. Sharp dissection of the skin subcutaneous tissue and platysma. Exposure of the external jugular vein and transection. Elevation of the subplatysmal flap. Exposure of the submandibular gland, accessorius nerve, internal jugular vein, omohyoid muscle and digastric muscle. There is a large metastasis in level II, which can be easily dissected from the non-lymphatic structures. Removal of the neck specimen from level II to level V while preserving all non-lymphatic structures. Multi-layer wound closure. Platys suture and skin suture with 5-0 Ethilon after placement of a 10-gauge Redon drain.