Introductory consultation with the anesthesia department. After appropriate preparation, the gastric tube is first inserted through the left nasal cavity, the correct position of which is then checked by auscultation. Skin disinfection. Infiltration with local anesthetic containing adrenaline in the area of the subsequent skin incision. Sterile washing and draping. Marking of the apron flap incision with the tracheostoma in place. Dissection of the apron flap and cranial fixation in the usual manner. Then perform the neck dissection, initially on the left side. After skeletonization of the sternocleidomastoid muscle, the auricularis magnus nerve is exposed and spared until the end. Displacement and, at the end of the operation, re-embedding of the auricularis magnus nerve in the sense of neurolysis. The same is done with the accessorius nerve. Displacement and re-embedding of the accessorius nerve at the end of the operation in the sense of a neurolysis. Skeletonization of the digastric muscle with exposure and protection of the hypoglossal nerve on the left side. Displacement and re-embedding of the hypoglossal nerve at the end of the operation. Opening of the cervical vascular nerve sheath and skeletonization of the internal jugular vein after identification of the vagus nerve. Regions II to V are then successively resected while preserving all non-lymphatic structures. Exposure of the lateral horn of the hyoid bone. Removal of the supralaryngeal vascular nerve bundle. Separation of the left larynx caudal to the hyoid bone. Exposure of the left lobe of the thyroid gland and lateral dissection. Separation of the straight neck muscles just above the clavicle. Undercutting of the isthmus, clamping, and removal and ligation on both sides. Separation of the constrictor pharyngis muscle from the thyroid cartilage and release of the piriform sinus on the left side. Transition to the opposite side. Similar procedure here. Here, too, there is no clinical evidence of a cervical lymph node metastasis. After complete mobilization of the larynx, the tracheostoma is first created. The 2nd tracheal clasp is incised in an H-shape and the caudal mucocutaneous anastomosis is created first. The lingual side of the epiglottis is then exposed through the pre-epiglottic fat body. Then open the pharynx and develop the larynx caudally along the epiglottis and the aryepiglottic folds. The tumor appears to be purely endolaryngeal. Both incisions are then connected caudally on the posterior surface of the cricoid cartilage. Dissection caudally up to the 1st tracheal clasp. The entire laryngeal preparation is then removed together with the 1st tracheal clasp. Circular marginal incisions are taken from the pharyngeal defect as well as from the specimen itself at the right sublaryngeal margin. All marginal incisions proved to be free of tumor and dysplasia. Myotomy of the constrictor pharyngis muscle. Insertion of a Provox voice prosthesis at the upper edge of the tracheostoma in the usual manner. Then suture of the pharyngeal defect with a continuous inverting Conley suture. The second suture layer is performed using single button sutures. Insertion of a Redon suction drain on both sides. Completion of the mucocutaneous anastomosis of the tracheostoma. Two-layer wound closure on both sides. Sterile wound dressing. Application of a pressure dressing. Final consultation with the anesthetist. Conclusion: Total laryngectomy with primary voice rehabilitation by insertion of a Provox voice prosthesis and myotomy of the constrictor pharyngis muscle, selective neck dissection of regions II to V on both sides and insertion of a nasogastric tube.