Transfer of the patient to the operating theater and positioning of the patient. Introductory consultation with the anesthesiologist and performance of the team time-out. With Cormack I, the patient can be intubated without any problems after an unremarkable tracheoscopy. Now start with esophagogastroscopy, here the esophagus and gastric mucosa are non-irritating, inconspicuous and without evidence of bleeding or a mass. Palpation and inspection of the oral cavity. The right tonsil is rough to palpate, especially in the upper area, the left tonsil is palpable without irritation, as is the base of the tongue. Now entering with the Kleinsasser tube C, the vallecula and epiglottis are inconspicuous, as is the base of the tongue; the pharyngeal side and posterior walls as well as the postcricoid region are also inconspicuous. With good adjustability, the larynx can be adjusted up to the anterior commissure, the vocal folds are also inconspicuous, the piriform sinus can be stretched open on both sides without any problems. Now insert the Mc Ivor blade and inspect the tonsil region on the right side. Here an exophytic mass is seen in the upper third of the tonsil, the caudal pole is free and can be luxated without difficulty, the middle of the tonsil and the upper pole can also be luxated without difficulty, but the exophytic mass in the cranial region extends approximately 0.5 cm from the upper tonsil pole to the anterior palatal arch. For this reason, the mucosal incision close to the uvula is made closer to the uvula than in a normal TE and a section of the anterior palatal arch is also resected, so that the tumor is incised by approx. 4 mm. Further careful dissection of the tonsil, the tonsil can be adjusted and luxated without any problems and the fibers can be stretched open and the tonsil separated from the tissue without any problems. The tonsil is not firmly attached to the tonsil bed at either end. Successive detachment of the tonsil without increased coagulation in the upper area to allow inspection of the wound edges. The resection is performed in the remaining area with a minimum distance of 7 mm, in the caudal area now dissection according to the dissection technique with bipolar coagulation and removal of the tonsil. The anterior and posterior palatal arch could be spared. Basally, the tonsil was removed deeper than in normal TE, but without opening the parapharyngeal space. Palpation revealed no further evidence of a mass in the tonsillar lobe. After careful hemostasis with bipolar coagulation, there is no evidence of increased bleeding. Relax for 5 minutes and wait, after reinsertion of the Mc Ivor spatula the wound bed is still dry. End the operation. Inspection of the tonsil. The upper pole in particular is hard to palpate, it is surrounded on all sides by easily movable mucosa, the exophytic mass is also removed by inspection and palpation in healthy tissue. The minimum distance of 4 mm on the anterior palatal arch is approximately 0.5 cm below the cranial pole. Suture marking and sending in the tonsil. Conclusion: cT1 cN2b tonsillar carcinoma on the right side. In today's operation, frozen sections were not performed and the specimen was sent for urgent histology. The histology should be discussed in the interdisciplinary tumor conference, including the performance of the neck dissection. The planning of the further procedure should be discussed.