Ablation of the surgical site. Application of local anesthesia in the area of the median line of the neck. Zigzag opening of the skin. Cutting through the subcutaneous tissue. Exposure of the linea alba. Exposure of the cricoid cartilage. Exposure of the ligamentum conicum. Exposure of the thyroid cartilage. Opening of the thyroid cartilage. An exophytically growing tumor is seen in the area of the left vocal fold, which extends to the anterior commissure and also spreads to the right side in the anterior third of the vocal cord. Resection of the tumor on the left side and in the area of the anterior third of the right vocal cord. The vocalis muscle can be partially preserved. The specimen is removed on the left side in the area of the vocal process of the arytenoid cartilage. The left morgue sinus and the pouch ligament are preserved. Now take marginal samples. These marginal samples show an invasive carcinoma in the area of the remaining right vocal fold. A further resection also reveals invasive carcinoma in the resected area, so that the right vocal fold is also completely resected and parts of the vocalis muscle are preserved. On the right side, the resection also extends to the vocal process of the arytenoid cartilage. Finally, the resection includes both vocal folds including the anterior commissure up to the vocal process of the arytenoid cartilage on both sides. The morgue sinus and pocket folds can be preserved on both sides, as can parts of the subglottic slope. The last frozen section examinations now show a resection in sano. Grinding of the cartilage in the area of the anterior commissure. Careful hemostasis. Insertion of a Keel. Closure of the thyroid cartilage. Reconstruction of the ligamentum conicum. Insertion of a flap. Wound closure in layers.