Tracheoscopy: Entry with O° optics, inconspicuous conditions. Intubation by the surgeon, orotracheal possible without any problems. Fixation of the 6.5 mm tube. Inspection of the pharynx, oral cavity and oropharynx with the Kleinsasser size B tube. In the area of the edge of the tongue, there is a mass measuring approx. 1.5 to 2.5 mm, which extends dorsally in the shape of a finger. In the area of the right anterior palatal arch there is a conspicuous epithelial change. Performance of gastroesophagoscopy: In this case, the esophagus and stomach were unremarkable on all sides. Decision to insert a PEG tube after viewing the primary tumor. After infiltration anesthesia of the skin under strict diaphanoscopic control, a 9 Charričre PEG tube was inserted. Adequate pressure of the holding plate, sterile dressing. First looping of the tongue on the holding thread. Epithelium, disinfection of the oral cavity with Octenispet solution. Now mark the area to be resected with the electric needle. Now use the bipolar and sharp resection to successively remove the tumor macroscopically in healthy tissue, the specimen is thread-marked in 3 places for frozen section diagnostics. Here, <CLINICIAN_NAME> selectively identifies a carcinoma in situ situation in the middle of the transition area between the tongue and the floor of the mouth. Here, an entire epithelial strip is resected again, now including the sublingual gland. Parts of the lingual nerve are also resected. In addition, a disc-like resection is also obtained from the wound bed in the caudal area as a marginal sample. Hemostasis with the bipolar. Identification of the lingual artery, which is ligated and stitched twice. Adapting sutures, the wound is left to secondary wound healing. If there is no bleeding, no further measures are required. Intraoperative demonstration of findings on <CLINICIAN_NAME>. Now turn to the right palatal arch. A 2 x 2 mm large, exophytically growing change on the base of a leukoplakia can be seen here. This is now removed in healthy tissue. Several leukoplakia are also found on the alveolar ridge. The specimen is sent separately for final histological evaluation. Suspicious for precancerous lesions. Bipolar coagulation at certain points. If there is no bleeding, repeat epithelial disinfection of the entire oral cavity with Octenisept. After skin disinfection and infiltration anesthesia on the left cervical side, start with the neck dissection after skin disinfection and marking of the incisions. Slightly curved, .................... Skin incision on the anterior edge of the sternocleidomastoid, separation of the platysma. Identification and ligation of the external jugular vein. Mobilization of the sternocleidomastoid, identification of the cervical vascular sheath with the internal jugular vein and the carotid artery. Now cranial dissection, identification of the accessorius nerve, cranial dissection up to the digastric muscle, protection of the rest of the accessorius nerve. On the digastric muscle, dissect anteriorly, detach and skeletonize the submandibular gland. Dissection of the V. facialis and the V. jugularis intera along the entire course to below the omohyoid muscle. Identification and partial dissection of the superior thyroid artery. A round, soft lymph node measuring 2 x 1.5 cm is found in the area where the V. facialis exits. This is now successively removed together with the surrounding connective tissue and level IIa is completely removed. Level Ib is also freed from connective tissue after skeletonization of the gland. The facial artery and facial vein are spared. Complete the medial neck preparation, taking away parts of the connective tissue that are above the prelaryngeal musculature. Dissection of the carotid bifurcation, identifying the cervical artery and sparing the entire cervical artery as the procedure progresses. The vagus nerve is also identified and spared. Now complete the lateral neck preparation after free preparation of the accessorius triangle and caudal preparation. Below the omohyoid, a caudal boundary to level IV is created, the sedimentation limits are defined with the bipolar and the preparation is fully developed. No bleeding or evidence of a chyle fistula at the end of the operation. Selective bipolar coagulation and placement of a Redon drain, two-layer wound closure.