After induction of anesthesia and intubation by the anesthesia colleagues, the first step is to use the small bore tube to inspect the local findings. Inconspicuous oral cavity and oropharynx. In the area of the laryngeal epiglottis, a largely exophytic mass is now seen, as described above, but in comparison progressive in size, which occupies the majority of the laryngeal epiglottis area, extends caudally to just before the petiolus, laterally just reaches the aryepiglottic fold on the left, extends over this on the right side to the pocket fold and here to just before the ary, but no ary infiltration. Now adjust the findings with the FK retractor. The resection is then performed under 30° optics in a robot-assisted manner with complete resection of the epiglottis via the vallecula down to the petiolus. No penetrating growth here, so that there is no extension into the pre-epiglottic space. Resection on the left side of the aryepiglottic fold up to the left side above the pocket fold, on the right side complete resection of the aryepiglottic fold up to the ary and partial removal of the pocket fold. For an overview, the tumor is successively resected and retracted using the piecemeal technique. Finally, covering marginal samples are taken. These are completely tumor-free, so that the overall situation is R0. Subsequent careful hemostasis. If the enoral situation is dry, perform selective neck dissection on both sides. Right-sided evacuation of levels II to IV with ligation of the external jugular vein and facial vein. Preservation of the auricular nerve after exposure of the surrounding musculature. Exposure and preservation of the superior thyroid artery, cervical artery, hypoglossal nerve, internal jugular vein, accessorius nerve. Overall, macroscopically no conspicuous nodules. Subsequent careful wound irrigation with H2O2 and Ringer's solution. Insertion of a 10-gauge Redon drain and careful, two-layer wound closure. Turning to the left side. Exactly the same procedure here. Exposure of the bordering musculature. Ligation of the external jugular vein, which also runs obliquely. Also ligation of the facial vein. Overall, as on the opposite side, significantly more difficult preparation conditions with marked obesity and extremely short neck. Free preparation and preservation of the hypoglossal nerve, superior thyroid artery, accessorius nerve, internal jugular vein. Deposition of the preparation, as on the opposite side, at the transition to level V. Careful hemostasis. Irrigate the wound with H2O2 and Ringer's solution. If the wound is dry, insert a 10-gauge Redon drain and carefully close the wound in two layers. Then perform the tracheotomy. To do this, make a horizontal incision at the level of the very deep cricoid cartilage. Cut through the skin and subcutaneous tissue. Exposure and transection of the infrahyoid musculature. Exposure of the cricoid cartilage. Exposure of the anterior surface of the trachea. Dissection of the thyroid isthmus. Insertion between the 1st and 2nd tracheal ring. Performing a wide tracheotomy. Incision of the tracheostoma in the usual manner. Subsequent problem-free transfer to a size 9 low-cuff cannula and repositioning of the patient. Completion of the procedure without any indication of complications. Note: The patient receives intraoperative intravenous antibiotics with Unacid 3 g, please continue this for 24 hours postoperatively. A nasogastric feeding tube should also be inserted intraoperatively. Please feed via this for 5 days, after which a swallowing test and, if necessary, a diet reconstruction are required. Due to the extensive supraglottic resection, there may be a protracted recovery of swallowing function.