After intubation anesthesia of the patient, initial inspection of the oral cavity, oropharynx and hypopharynx with the Kleinsasser tube. This reveals a spherical mass in the area of the base of the tongue, which is covered by smooth mucosa, with otherwise normal, inconspicuous mucosal conditions and a relatively narrow pharynx. Then reposition the patient and insert the Fentex retractor and expose the base of the tongue. Extremely difficult to adjust here. In the end, however, it was possible to expose the tumor completely. Then insertion of the robotic instruments. Start the resection tangentially at the base of the tongue so that the tumor can be excised circularly with a sufficient safety distance to the tumor. This is done using monopolar coagulation and subtle hemostasis. Several marginal samples are then taken and sent in as frozen sections for histopathological tissue examination. These are found to be tumor-free intraoperatively. Subtle hemostasis again. Then removal of the robotic instruments and the Fentex retractor. Due to significant swelling in the area of the entire hypopharynx, the decision was made to tracheostomy the patient after he could only be intubated bronchoscopically by the anesthesia colleagues. This measure is carried out as a protective intubation. The patient is then repositioned, the neck is abducted and local anesthetic with adrenaline is injected. Then pretracheal skin incision and layered preparation in depth. Dissection of the pretracheal muscles in the midline, which is then dissected to the side. Exposure of the thyroid isthmus. This is undermined and dissected after careful coagulation. Exposure of the anterior surface of the trachea. Then incision of the trachea between the 2nd and 3rd cartilage clasp. Preparation of a Björk flap. Then circular suturing of the trachea in the sense of anastomosis to the skin. Then insertion of an 8-bore tracheostomy tube through which the patient can initially continue to be ventilated without any problems. The procedure is then completed. Repeated enoral bleeding control, here dry wound conditions. The decision was therefore made to end the procedure and allow the patient to wake up, which was done without any problems. Further procedure depending on the result of the histopathological examination.