Induction of anesthesia and intubation by the anesthesiology colleagues, followed by an examination of the glottis region and the trachea using a rigid 0° scope. An exophytic tumor was found, starting at the morgue sinus on the left side with transition to the vocal fold and subtle subglottic extension. Then intubation by the surgeon. Further inspection with the Kleinsasser tube and confirmation of the findings. The right arytenoid cartilage as well as 3/4 of the right vocal fold and also the pocket fold are not affected on the right side, therefore an attempt is first made to remove the larynx subtotally and preserve the rest. At the beginning, the flexible esophagoscope is used to enter the larynx and the stomach is viewed, which is normal on all sides. Then attempt to perform a diaphanoscopy; this is not possible, even after repositioning the patient, so a PEG is not inserted. Now insertion of a nasogastric tube and fixation of this to the septum. Then sterile washing and draping. First start with the tracheostomy. To do this, make a skin incision below the cricoid cartilage and dissect the thyroid gland. This reveals a large thyroid nodule on the left side. Dissection of the thyroid isthmus and exposure of the anterior wall of the trachea. Insertion between the 3rd and 4th tracheal cartilage and creation of a tracheotomy. Re-intubation, then sterile washing and draping again. Then creation of an apron flap in the usual manner. This is complicated as the patient has undergone 3 ventral operations on the cervical spine and there is scarring here. Exposure of the larynx, release of the larynx, release of the piriform sinus on both sides. Cut the sternohyoid muscle on both sides and then enter the supraglottic larynx from the right and inspect the tumor region. The tumor is now carefully cut around from the posterior side while preserving the epiglottis. Further incision is made caudally. The right arytenoid cartilage as well as 3/4 of the right vocal fold and 3/4 of the pocket fold can be preserved on the right side. Not on the left side. Then further dissection caudally. Exposure of the cricoid cartilage. It is now clear that the cricoid cartilage is macroscopically infiltrated on the left side; the arytenoid on the left side must also be resected down to the interary region. Therefore, the concept of partial laryngectomy is abandoned and a laryngectomy is performed. The larynx is now removed below the cricoid cartilage. Removal of marginal samples, these are sent for histology, all marginal samples are tumor-free. In the pharyngeal side wall on both sides, there is still evidence of carcinoma in situ, therefore another resection and another final marginal sample is taken and sent for final histology. Macroscopically no evidence of tumor, especially on the right side there had never been a tumor. Then completion of the neck dissection. Instead, visualization of the anterior border of the sternocleidomastoid muscle on both sides. Exposure of the accessory muscle, exposure of the cervical vascular sheath. Free preparation of the internal jugular vein and removal of the neck preparation while protecting the plexus branches on both sides. Then placement of a Provox prosthesis size 8.0 Provox Vega in the usual manner. Then perform a lateral esophageal myotomy on the left side in the usual manner. Resection of the insertions of the sternocleidomastoid muscle. Insertion of 2 Redondra rings. Then pharyngeal suture in 3 layers in the usual manner. The base of the tongue was partially released beforehand. At the end, two-layer wound closure and suturing of the tracheotoma. Insertion of a 10 mm tracheostomy tube and completion of the procedure without complications. Collar dressing at the end. Antibiotics for 24 hours and neck bandage for one week. X-ray pre-swallow from the 10th postoperative day.