Introductory consultation with the anesthesia department. Positioning of the patient. Insertion of the mouth blocker. Exposure of the tumor. After TE, a flat tumor is seen in the right tonsil region, which extends to the soft palate and reaches the posterior edge of the alveolar ridge. Therefore, first mark the cut surfaces with the monopolar needle. Then cut around the preparation with the monopolar needle. The preparation is mainly made with the electric needle and now extends over the anterior and posterior palatal arch to the muscles of the lateral pharyngeal wall and the posterior pharyngeal wall. The tumor does not appear to have grown into the deep muscles of the pharynx, so that the incision plane in the area of the pharyngeal muscles can be maintained over the entire resection area. The tumor is removed at the transition to the hypopharynx. The specimen is thread-marked for histopathological examination. A primary R0 resection is found, but with narrow resection margins in the dorsal and caudal region, so that a resection and new margin sampling is performed. The safety margin after resection is now certainly 5 mm in all planes. Once again meticulous hemostasis. If the wound is dry, remove all instruments. Repositioning of the patient for neck dissection on the right side. Injection of local anesthetic with adrenaline. Position and cover the patient. Skin disinfection. Incision along the anterior edge of the sternocleidomastoid muscle. Layer-by-layer dissection in depth and separation of the platysma. Exposure of the cervical vascular sheath. Insertion of the retractors. Dissection of the cervical vascular sheath. Here, long-distance vascular dissection along the internal jugular vein with the exit of the facial vein. Long-distance exposure of the vagus nerve. Displacement to the medial side and at the end of the operation re-embedding of the vagus nerve in the sense of a neurolysis. Long-term exposure and dissection of the accessory nerve. Displacement and, at the end of the operation, re-embedding of the accessory nerve in the sense of a neurolysis. Resection of the lateral neck preparation in the plane of the deep cervical fascia while sparing the cervical plexus branches. The accessorius nerve, vagus nerve and phrenic nerve are also spared. Subsequent dissection of the hypoglossal triangle. This also involves long-distance dissection of the hypoglossal nerve with the cervical profunda. Displacement and, at the end of the operation, re-embedding of both nerves in the sense of a neurolysis. Dissection of the anterior neck preparation, sparing all branches of the internal jugular vein and the external carotid artery. Exposure of the capsule of the submandibular gland, which is partially resected. Finally, this results in neck dissection of levels I b to V. Subtle hemostasis is performed. Insertion of a Redon drain. Two-layer wound closure. Application of a pressure dressing. Repeated enoral bleeding control. Dry wound conditions. Final consultation with the anesthetist.