First, induction of anesthesia by the anesthesia colleagues. Then direct laryngoscopy with the small bore tube and confirmation of findings and indication by <CLINICIAN_NAME> and insertion of a nasogastric tube. Sterile wiping and draping. Skin incision. Dissection of the subcutaneous tissue and the platysma and formation of a subplatysmal apron flap in the typical manner. First dissection of the prelaryngeal and pretracheal fatty tissue in the sense of a level VI neck dissection, followed by exposure and dissection of the prelaryngeal musculature. Exposure of the thyroid isthmus. Dissection of the thyroid gland and visualization of the anterior wall of the trachea. Identification of the hyoid bone. Skeletonization of the hyoid bone and transection of the inferior constrictor muscle along the thyroid cartilage from both sides. Opening of the trachea against the second tracheal ring and re-intubation. Dissection in the direction of the vallecula up to the mucosal level. Opening of the vallecula and exposure of the epiglottis. Disluxation of the epiglottis. Incision along the lateral edges of the epiglottis and along the aryepiglottic folds on both sides. Strict care is taken to maximally preserve the mucosa of the piriform sinus on both sides. The incision is made in the postcricoid area and the mucosa of the hypopharynx is pushed away from the laryngeal skeleton and further dissection between the oesophagus and the posterior wall of the trachea. The larynx is then completely removed. This reveals a large macroscopic safety margin. A frozen section of the postcricoid region and tracheal separation border is sent for frozen section and later assessed as free of carcinoma. Then neck dissection on the right side. Identification of the anterior border of the sternocleidomastoid muscle. Dissection along the jugular vein in a cranial direction. In the cranial section, identification of the accessorius nerve and sparing of the accessorius nerve. The hypoglossal nerve is also identified and spared here. Level II b is then removed. Slide the preparation below the accessorius nerve. Further placement of the preparation caudally with protection of the cervical plexus branches. Modified functional neck dissection Level II to IV is performed, followed by neck dissection on the left side. Here also dissection along the anterior border of the sternocleidomastoid muscle. Exposure and sparing of the accessorius nerve. Exposure of the posterior venter of the digaster muscle and exposure of the internal jugular vein as well as the vagus nerve and the common carotid artery. Dissection along the cervical vascular sheath from caudal to cranial. Successive removal of the posterior and anterior neck preparation while protecting the above-mentioned structures and the plexus branches. A tracheoesophageal fistula is then created and a Provox prosthesis size 10 is inserted approx. 1 cm caudal to the upper tracheal margin. Subsequent palpation of the esophageal entrance. This revealed a relatively wide esophageal entrance. A myotomy was performed on the left side to prevent subsequent narrowing. Adaptation of the tracheal free edge with the stoma and fixation with Ethibond suture. Irrigation of the wound area with hydrogen and Ringer. Hemostasis. Subcutaneous and skin suturing and completion of the procedure without complications. Note: Nasogastric tube until the 10th postoperative day, then perform an X-ray gruel swallow, if this is inconspicuous, then diet build-up. Continue antibiotics for a total of 1 week.