After active patient identification, the patient is brought into the operating theater. Carrying out the team time-out. Introductory consultation with the anesthesiologist. Induction of anesthesia and intubation of the patient. Positioning of the patient by the surgeon. First insertion of the McIvor oral spatula while protecting the teeth, lips and tongue. The resection margins are then marked using the electric needle. While maintaining the necessary safety distance, the tumor is now resected successively, taking the right tonsil with it. The extent of the resection extends to the alveolar ridge in the area of the former last and penultimate molar. A large part of the glossotonsillar groove is also resected. Clinically macroscopically clear in sano resection. The preparation is now sent in marked with a thread for frozen section diagnostics. In addition, a further marginal sample is taken from the glossotonsillar groove via the mucosa of the alveolar ridge to the anterior palatal arch. During the intraoperative frozen section, the tumor is classified as R0 on the specimen. The additional marginal sample taken is also free of tumor and carcinoma in situ. Hemostasis by means of bipolar coagulation. Insertion of an H2O2-soaked extracted hydrogen compress. Transition to neck dissection. First skin spray disinfection and infiltration anesthesia. Skin wipe disinfection and sterile draping. Marking of the mandibular arch and the ascending mandibular branch. Marking of the planned incision from the mastoid, extending into a submandibular skin fold and curving out at the anterior edge of the sternocleidomastoid muscle. Sharp cutting of the cutis as well as the subcutis. Cutting through the platysma. Insertion of the sharp retractors. Exposure of the anterior edge of the sternocleidomastoid muscle. Exposure of the external jugular vein and the auricularis magnus nerve. Both structures can be preserved. Displacement and, at the end of the operation, re-embedding of the auricularis magnus nerve in the sense of a neurolysis. Exposure of the omohyoid muscle as a caudal boundary. Exposure of the posterior digastric venter muscle as the cranial border. Turning to the cervical vascular sheath. Visualization of the internal jugular vein and the small venous angle. Identification of the accessorius nerve. Subsequent clearing of the lateral neck preparation via level II b, II a, III up to level IV, sparing all plexus branches. As part of the dissection, the common carotid artery, the bifurcation and the internal and external carotid artery are also exposed. The vagus nerve is also exposed and protected. Displacement and, at the end of the operation, re-embedding of the accessorius nerve and vagus nerve in the sense of a neurolysis. Subsequently turn to the medial neck preparation. First identification of the hypoglossal nerve. Protection of the same. Displacement and, at the end of the operation, re-embedding of the hypoglossal nerve in the sense of a neurolysis. Successive development of the medial neck preparation while leaving the submandibular gland intact. Hemostasis by means of bipolar coagulation. Wound irrigation with H2O2 and Ringer's solution. Insertion of a 10-gauge Redon drain. Removal of the retractors. Subcutaneous suture with Vicryl 4-0 and skin suture with Ethilon 5-0. Application of a wound dressing and a pressure bandage. Finally, enoral inspection. Again, no evidence of a persistent source of bleeding. Removal of the H2O2-soaked extracted dressing. Completion of the operation without complications. A nasogastric tube is then inserted by the anesthesia colleagues. Final consultation with the anesthesia department.