Initially induction of anesthesia and transnasal endotracheal intubation by the anesthesia colleagues. A tracheoscopy was performed beforehand. Inconspicuous conditions in the area of the trachea up to the carina. Positioning of the patient by the surgeon. Then perform a laryngoscopy using a small water C-tube and then demonstrate the findings to <CLINICIAN_NAME> with confirmation of the indication for the above measures. Followed by cervical skin spray disinfection. Application of local anesthesia cervically, medially and laterally on both sides. Skin ablation and sterile draping. Creation of a skin incision. Separation of the subcutaneous tissue and the platysma and formation of a subplatysmal apron flap. Development of the subplatysmal apron flap up to the level of the capsule of the submandibular gland on both sides and the hyoid bone. Exposure and ligation of the external jugular vein on the left side. Sparing of the external jugular vein on the right side. Subsequent exposure of the anterior border of the sternocleidomastoid muscle on the right side. Exposure and sparing of the auricular nerve. Exposure of the posterior venter of the digaster muscle. Exposure of the omohyoid muscle. Exposure of the internal jugular vein, the vagus nerve and the cervical vascular sheath. Exposure of the cranial hypoglossal nerve. Exposure and sparing of the facial vein. Successive evacuation of region I b to V on the right side while sparing the above-mentioned structures and the plexus branches. Successive evacuation of the anterior preparation. Exposure and ligation of the superior thyroid artery. During the neck dissection on the right side, several suspicious lymph nodes were found in levels III and IV. Hemostasis there using bipolar coagulation and subsequent exposure of the anterior border of the sternocleidomastoid muscle on the left side. Exposure and sparing of the auricular nerve. Exposure of the posterior venter of the digaster muscle. Exposure of the accessorius nerve. Exposure of the omohyoid muscle and the cervical vascular sheath. Successive evacuation of regions I b, II, III, IV and V on the left side. Successive evacuation of the anterior neck preparation while sparing the hypoglossal nerve and the facial vein. Hemostasis there by means of bipolar coagulation. The specimens are removed caudally, after making several incisions. Dry conditions. Subsequent skeletonization of the hyoid bone using an electric knife. Deposition of the infrahyoid muscles caudally. Subsequent scalpel incision in the area of the midline of the thyroid cartilage. Subperichondral dissection. Continuation of the subperichondral dissection on the inner surface of the thyroid cartilage. Maximum protection of the wall of the piriform sinus on both sides. Subsequently expose the thyroid isthmus, undermine and cut through it. Scalpel incision between the 3rd and 4th tracheal cartilage clasp. Fixation of the lower edge of the tracheostoma to the skin and reintubation of the patient onto a laryngectomy tube. Followed by median pharyngotomy. Exposure of the free edge of the epiglottis. Successive dissection along the lateral edge of the epiglottis on both sides. Incision along the aryepiglottic folds on both sides. In doing so, protect the wall of the piriform sinus on both sides. Transverse incision in the postcricoid area. Joining the lateral incision with the postcricoid incision. Exposure of the posterior cricoarytaenoid muscle in the region on both sides, which is included in the preparation. Successive dissection between the anterior wall of the oesophagus and the posterior wall of the trachea. Protect the anterior wall of the esophagus and then place the specimen at the level of the tracheostoma. The specimen is sent for intraoperative frozen section examination marked with a suture (anterior edge of the trachea). The following edge samples are also sent for frozen section: Anterior wall of the right piriform sinus, anterior wall of the left piriform sinus, postcricoidal mucosa, base of the tongue thread-marked on the right. The intraoperative frozen section examination reveals an R0 situation. A size 8 Provox prosthesis is subsequently placed without any problems and the pharyngeal suture is then performed. First, the mucosa is sutured together continuously in an inverted position, taking great care to ensure that no parts of the mucosa are visible after the first suture has been applied. In the 2nd step, the submucosa is sutured together. In the 3rd step, the muscular parts of the pharyngeal suture and the base of the tongue are sutured together. In the 4th step, the pharyngeal suture is reinforced with pieces of Tachosil along the entire length. In the 5th step, the infrahyoid muscles are readapted in the midline. Subsequently, transverse incision of the sternocleidomastoid muscle on both sides near the clavicular insertion. Placement of a 10 Redon drain on both sides. Completion of the epithelialization of the tracheostoma. Two-layer wound closure and application of a pressure dressing. Completion of the procedure without complications. Please feed via the nasogastric feeding tube and perform an X-ray gruel swallow on the 10th postoperative day.