First of all, MLE once again: positioning of the tumor. This sits broadly in the area of the anterior vocal fold, sits broadly in the area of the anterior commissure, extends subglottically and extends almost to the middle of the vocal fold on the right, but here superficially. Tumor also extends anteriorly somewhat to the supraglottic and left anterior transition towards the ventriculus laryngis. However, the free mucosal margin is still clearly visible. The next step is laser resection with a 4 watt pulsed laser; the tumor is removed in several fractions. Complete resection of the left vocal fold up to the arytenoid cartilage is performed, including the subglottic slope up to the cricoid cartilage as well as the laryngeal ventricle and parts of the left pouch ligament at the front. The supraglottic area is also resected in the front. Resection extends to the right, here the anterior part of the vocal fold is resected according to the real superficial extent of the tumor. In the anterior area, extending to the right and left, the thyroid cartilage is exposed from the supraglottic area down to the cricoid cartilage. Cartilage areas macroscopically free. Removal of the soft tissue is possible without visible tumor contact. Marginal samples are now taken from the subglottic area, from the cricothyroid membrane area and from the anterior commissure area. A marginal sample is also taken from the entire surface of the right vocal cord. In addition, a left dorsal marginal sample from the arytenoid region, left caudal, left cranial and left basal. In the frozen section, except for the left dorsal margin sample, in which carcinomas are still detectable in situ, all margin samples are healthy. Therefore, the resection in the arytenoid region is now carried out again with the laser, including parts of the anterior arytenoid cartilage. In addition, a strip of mucosa from the entire posterior area is sent in again as a marginal sample for the frozen section. No more infiltrates detectable here. Thus R0 resection status. Careful hemostasis is performed with supratabs and monopolar. No bleeding at the final inspection. Completion of the procedure without complications. Overall extensive laser resection of a cT2 carcinoma. The thyroid cartilage and cricoid cartilage are exposed anteriorly and laterally, more on the left than on the right, as is the cricothyroid membrane. For this reason, the patient was given Sobelin intraoperatively. Antibiotics should be continued for about 1 week. Postoperatively, due to the extent of the tumor and after laser resection, control MLE is essential after 10 to 12 weeks.