Transferring the patient to the operating theater . Patient identification. Carrying out the team time-out in the usual manner. Induction of intubation anesthesia by the anesthesia colleagues. Start of the operation with panendoscopy. Inspection of the endolarynx: a transglottic laryngeal carcinoma is found in the area of the right pocket fold and supraglottic, growing to approx. 2 cm subglottically. The tumor dominates on the right side, extending over the anterior commissure to half of the left vocal fold. Retraction of the small siphon tube and inspection of the lesions described in the CT scan in the area of the right vallecula. This shows a ruptured vallecula cyst. To rule out malignancy, samples are taken and sent for frozen section diagnostics (frozen section not malignant). Inspection of the right glossotonsillar groove: if the mucosa is normal, superficial PEs are also taken to rule out malignancy (frozen section, also non-malignant). Insertion of a nasogastric tube. Removal of the small esophageal tube and insertion of the flexible gastroesophagoscope into the esophagus and careful advancement into the stomach. Check the stomach again. The mucosa is found to be free of irritation on all sides. Insertion of a PEG tube in the usual manner using the thread pull-through method without complications. The patient is then repositioned in a head down position. Injection of xylocaine with the addition of suprarenin. Sterile abjodation and draping of the patient. Start with the tracheotomy: skin incision below the cricoid cartilage. Separation of the subcutaneous tissue. Separation of the platysma. Identification of the superficial neck muscles and incision in the midline. Lateralization of the neck muscles with the retractors. Identification of the thyroid isthmus. Undermining of the isthmus with the clamp and transection of the isthmus after bipolar coagulation. Identification of the anterior wall of the trachea. Freeing the trachea from the surrounding tissue. Due to the previously described subglottic extension of the tumor, the tracheotomy is performed deep (between the 4th and 5th tracheal cartilage). Suturing at the caudal wound edge and insertion of an LE tube. Continuation of the operation with incision of the apron flap. Separation of the skin, subcutis and platysma. Subplatysmal dissection up to the exposure of the hyoid bone and the submandibular gland on both sides. Opening of the glandular capsule and detachment of the submandibular gland from the glandular bed on both sides. Identification of the anterior border of the sternocleidomastoid muscle on the right side to perform the neck dissection. Neck dissection on the right by <CLINICIAN_NAME>: After identification of the sternocleidomastoid muscle, dissection down to the deep cervical fascia. In doing so, protect the plexus branches of the cervical plexus. Exposure of the accessorius nerve and free dissection. The nerve can be safely spared. Identification of the posterior venter of the digastric muscle. Identification of the omohyoid muscle and tracing of the muscle to the hyoid bone. Dissect the internal jugular vein while safely identifying and protecting the common carotid artery and the vagus nerve. Now detach the neck preparation from region II to IV from cranial to caudal from the deep cervical fascia while protecting the plexus branches. Minor bleeding is coagulated bipolarly. Neck dissection on the right side is successful without any problems. The same procedure is now performed on the left side by <CLINICIAN_NAME>. Overall, there are no macroscopically clearly suspicious lymph nodes, although the lymph nodes are clearly enlarged and enlarged on both sides. Free preparation of the hyoid bone by loosening the supra- and infrahyoid muscles. On the left side, the infrahyoid musculature is completely folded caudally. On the right side, it is cut in the midline in order to avoid dissecting into the tumor as much as possible. Removal of the hyoid bone. Release the oblique laryngeal muscles on the right and left side with careful dissection. This can be done without any problems and without any evidence of soft tissue infiltration. Now release the upper edge of the thyroid cartilage. Careful dissection of the piriform sinus from the thyroid cartilage on both sides. Enter the pharynx on the left side. Then disluxation of the epiglottis and incision of the mucosa at the edge of the epiglottis to behind the arytenoid region on both sides. Subsequent removal of the larynx below the cricoid cartilage. Removal of the larynx and collection of several representative marginal samples by <CLINICIAN_NAME>. After removal of the larynx, a Provox prosthesis is placed in the usual manner. In addition, a myotomy of the esophageal inlet is performed. The two-layer pharyngeal closure is performed in the usual manner. In addition, as much preserved muscle as possible is placed over the suture in a 3rd step. Retraction of the apron flap Incision of the tracheostoma and two-layer wound closure using subcutaneous and cutaneous sutures. Application of a wrap bandage. Please continue antibiotics for at least 24 hours. Nutrition via the PEG tube. The dressing must be changed daily and should be left in place for a total of 1 week. X-ray gruel on the 12th to 14th postoperative day.