Transfer of the patient to the operating theater. Carry out another panendoscopy. Head declination by the surgeon and insertion with the Kleinsasser tube size C. An approx. 3 cm large, partially exophytic mass is seen extending from the lower tonsil pole into the base of the tongue. The midline is not crossed. The piriform sinus is tumor-free. The other findings in the mirror are unremarkable. Perform a flexible gastroesophagoscopy. The mucosal conditions are also unremarkable here. Insertion of a PEG tube using the thread pull-through method in the usual manner without complications. Insertion of the Spantex. Insertion of the mouth blocker and docking of the robotic arms. Adjustment of the robotic arms and positioning of the tumor under endoscopic control. Start with tumor resection from the cranial part to the caudal side. This is done without further bleeding. Removal of the tumor specimen. Obtain several representative marginal samples from the tumor bed. Sending for frozen section diagnostics: The frozen sections are tumor-free. Repeated site check: dry wound conditions on all sides, no evidence of bleeding. Removal of the robotic arms and completion of the tumor resection without complications. Now injection of Supra and wiping of the neck for neck dissection. Start of neck dissection on the left side. Separation of the skin and subcutaneous tissue as well as the platysma at the anterior margin of the sternocleidomastoid muscle 2 QF below the mandible. Dissection of a subplatysmal flap. Identification of the submandibular gland. Dissection along the muscle in depth down to the deep cervical fascia. The plexus branches of the cervical plexus are spared. Identification of the accessorius nerve. There is a metastasis-like mass lateral to the nerve, adjacent to the digastric muscle. From the underside, the internal jugular vein can be reliably separated from the mass by dissection. The accessory nerve can also be safely removed from the metastasis. There are no signs of infiltration. Now detach the remaining neck preparation from the depths while sparing the plexus branches. Identification of the common carotid artery and the vagus nerve. These can be spared without any problems. Identification of the hypoglossal nerve. This should also be spared. Placement of a 10-gauge Redon drain and two-layer wound closure. Now turn to the right side. Here also incision of the skin and subcutaneous tissue. Incision of the platysma and creation of a platysmal flap. Identification of the submandibular gland. Removal of the submandibular gland from its glandular bed. Identification of the digastric muscle. Identification of the accessorius nerve. Division of the neck preparation on the internal jugular vein. Identification of the vagus nerve and common carotid artery. Detachment of the neck preparation on the right side from the depth while sparing the plexus branches. No metastasis-suspicious nodes are visible on the right side. Completion of the neck dissection without complications. As on the left side, the right side is also irrigated with hydrogen and Ringer. Dry wound conditions at the end of the operation. Placement of a 10-gauge Redon drain and two-layer wound closure. The operation is completed without complications.