Before neck dissection and tracheotomy, laser resection of the T2 supraglottic carcinoma and PEG placement are performed first. PEG insertion first: The esophagoscope is inserted into the stomach without any problems. Inconspicuous conditions there. Good diaphanoscopy. Insertion of the PEG using the thread pull-through method in the usual way without complications. Now adjustment of the laryngeal entrance and the epiglottis with the spreading laryngoscope. A tumor can be seen on the laryngeal epiglottis, which, as described above, touches the aryepiglottic fold on the right, extends to the arytenoid cartilage and infiltrates into the pocket fold. In addition, the vocal fold is not fully reached on the right side. On the left, extending beyond the median line, moving towards the pocket fold, but clearly not reaching the vocal fold here. First of all, cutting around the entire epiglottis with the laser and partial resection of the upper and cranial part of the tumor. Resection anteriorly up to the pre-epiglottic fatty tissue. Splitting of the epiglottis attachment in the area of the petiolus and initial removal and resection of the tumor in the left larynx, up to the pocket crease, into the anterior commissure and into the pre-epiglottic fatty tissue. Resection clinically in healthy tissue. After resection of this part, incision of the aryepiglottic fold and insertion into the larynx. Resection of the entire pocket fold. Exposure of the thyroid cartilage and resection up to the vocal fold. The lower part of the vocal fold remains completely intact up to the anterior commissure at the transition to the left pocket fold. Finally, resection in the area of the right arytenoid. Another piece is removed here. Clinically now complete resection of the tumor. Thyroid cartilage partially exposed or still covered with perichondrium in some places. Circular margin samples are now taken, all of which are found to be tumor-free in the frozen section. An R0 resection can be assumed. Extensive hemostasis during the operation with repeated monopolar and bipolar coagulation. Finally, insertion of a swab with H2O2. This is removed again at the end of the operation. Repositioning of the patient and neck dissection with tracheotomy. Tumor resection was performed (previous procedure by <CLINICIAN_NAME>) Takeover now for neck dissection on both sides. Beginning on the right side: An existing old scar can be seen in the area of the larynx. This is also used for the incision. Therefore, an atypical incision is made here in order to take the old scar structure with it. Dissect down to the sternocleidomastoid. Locate the omohyoid muscle and digaster muscle as the upper and lower structure. Locate the accessorius nerve. Dissecting along the vein. Locating the vagus nerve. Removal of the lateral neck preparation. Now remove the medial neck preparation including the submandibular capsule. Locate and protect the hypoglossal nerve. Irrigation with hydrogen and Ringer. Insertion of a Redon drainage. Subcutaneous suture. Skin suture. Summary: Several suspicious lymph nodes, especially in region III. Now repositioning and start on the left side: Here now slightly similar incision as on the right in the area of the tension lines in order to maintain symmetry. Dissect down to the sternocleidomastoid muscle. Dissect down to the omohyoid and digaster. Locate the accessorius nerve. It can now be seen that the bulb of the carotid artery is located laterally, the vagus nerve is on the outside and the vein itself is located medially as a normal variant. Locate the hypoglossal nerve. This is also prominently exposed. The lateral neck preparation is now dissected out, possibly sparing the plexus branches, as on the right side. The medial parts of the neck and the submandibular capsule are also removed. Followed by hydrogen irrigation, Ringer irrigation. Insertion of a Redon drainage. Subcutaneous suture. Skin suture. Regio III/IV enlarged nodes also appeared on the left side. Now repositioning and tracheotomy: Kocher collar incision. Dissection down to the thyroid gland. Undermining of the same. Passing through the isthmus, repositioning. Formation of a Björk flap after entering the trachea. Suturing it to the skin. Skin suture. Then reintubation with an 8-gauge cannula. Now inspection of the laryngeal resection margin: Small hemorrhage in the anterior and lateral part. These are monopolar coagulated. No more bleeding afterwards. The inserted compress is removed and the procedure is completed. No bleeding at the end of the procedure, no complications. The previously performed measures are dictated separately by <CLINICIAN_NAME> or <CLINICIAN_NAME>.