First induction of anesthesia and intubation by the anesthetist. Entry with the Kleinsasser tube and inspection of the glottis. Advance the microscope. An exophytic mass is seen in the area of the left vocal fold with transition to the pocket fold and extension into the subglottic slope by approx. 0.5 to 1 cm. The mass passes over the anterior commissure to the opposite side and also extends on the left side into the postcricoid region. Due to the extent of the tumor, the age of the patient and the structure of the patient, decision to perform a laryngectomy. Repositioning of the patient. Sterile washing and draping. Creation of an apron flap. Start with neck dissection on the left side. Exposure of the sternocleidomastoid muscle, the submandibular gland, the omohyoid muscle, the posterior belly of the digaster muscle. Exposure of the cervical vascular sheath. Dissection of the internal jugular vein. Release of the medial neck block. Striking the medial neck block dorsally. Release the neck levels II a to V a while sparing the plexus branches. Now expose and detach the thyroid gland from the laryngeal skeleton. Detachment of the cervical vascular sheath from the laryngeal skeleton. Exposure of the upper laryngeal bundle. Ligation of this. Exposure of the left part of the hyoid bone. Change to the opposite side. Now first expose the sternocleidomastoid muscle and the omohyoid muscle. Then exposure of the posterior belly of the digaster and exposure of the cervical vascular sheath. Exposure of the internal jugular vein. Release of the neck block in the medial area and then release of neck levels II a to V a while sparing the plexus branches and the accessorius nerve. Exposure of the thyroid gland. Detachment of the thyroid gland from the laryngeal skeleton. Exposure of the upper laryngeal bundle. Ligation of the laryngeal bundle. Exposure of the hyoid bone. Release of the hyoid bone. Detachment of the infrahyal musculature. Skeletonization of the larynx. Transition to the tracheotomy. This is placed relatively far down, between the 3rd and 4th tracheal cartilage, due to the subglottic expansion. Exposure of the anterior wall of the trachea. Insertion between the 3rd and 4th tracheal cartilage. Fixation of the skin in the caudal area to the trachea and reintubation onto a laryngectomy tube. Release of the piriform sinus first on the right side, then on the left side. Enter the pharynx just above the hyoid bone. Disluxation of the epiglottis. Incision of the pharynx along the epiglottis up to the postcricoid region on both sides. Detachment of the entire laryngeal preparation up to the trachea. Separation of the larynx below the cricoid cartilage so that the tumor is also safely removed in the subglottic region. Inspection of the specimen. The specimen is sent for final histology. Insertion of a size 8 voice valve prosthesis using the pull-through method. An esophagomyotomy is not performed as the esophagus can be passed without any problems. Then myotomy of the attachment area of the sternocleidomastoid muscle on both sides and transition to the pharyngeal suture. The pharynx is sutured over in two layers using the usual technique and then a third layer is formed by the remaining prelaryngeal muscles and soft tissue. Wait for the histology. Feeding of the patient for 10 days via the nasogastric tube and X-ray pre-swallow on the 10th postoperative day. Then, depending on the result, diet build-up. Presentation of the patient at the tumor conference.