Transferring the patient to the operating theater and positioning the patient. Introductory consultation with the anesthesia department and performance of the team time-out. If the tooth status is poor, insert the mouthguard and insert the small irrigation tube. The tube is removed for this purpose. Inspection with 0° optics. Here you can see an exophytic mass affecting the entire left vocal fold and extending into the laryngeal ventricle and the subglottis. The anterior commissure is also infiltrated and the anterior 3 mm of the right vocal fold. With Cormack I, the patient can also be adjusted very well with the size C small bore tube. However, due to the infiltration of the anterior commissure, the mass is not laser resectable. Now demonstration of the findings to <CLINICIAN_NAME>, who advises a partial resection of the larynx according to Leroux-Robert. For this reason, placement of the accesses and the permanent catheter from the anesthesia. Injection, sterile ablation and draping. Marking the landmarks. Skin incision in a zigzag shape and dissection through the subcutaneous fatty tissue. Exposure of the prelaryngeal musculature and separation from it in the linea alba. Exposure of the larynx from the thyroid incisura to the cricoid cartilage. Exposure of the larynx in the sense of a dissection of the periosteum. Now saw open the larynx paramedian on the right side and cut the ligamentum conicum at this point. Open the larynx and inspect it. The larynx is opened paramedianally on the right side in order to be able to resect the anterior commissure and the anterior part of the right vocal fold. No tumor is now macroscopically visible here. The larynx is stretched open and the tumor is followed to the left side. Here the tumor is successively removed with the pointed scissors and the 15 mm scalpel as well as bipolar coagulation at a distance of approx. 1 cm. Basally, the thyroid cartilage is completely exposed and freed from the periosteum with the Freer. This is done without any problems and can be pushed off easily. Now successive further dissection of the tumor under suture marking and taking of the marginal samples during the resection. The proc vocalis of the arytenoid cartilage is infiltrated in the posterior region. For this reason, add <CLINICIAN_NAME> and <CLINICIAN_NAME>. As the remaining part of the arytenoid cartilage can remain in place and swallowing should therefore be possible and a tracheostomy should be avoided, the vocal process is removed and the remaining arytenoid cartilage is left in place. Now take circular margin samples. Make 4 drill holes through the thyroid cartilage. Careful hemostasis and waiting for the frozen section. This was found to be tumor-free everywhere, with infiltrates only visible in the paraglottic space on the left side. This is resected again and circular margin samples are taken again. These are again sent for frozen section and are tumor-free. An R0 situation can therefore be assumed in the frozen section. It must be expressly mentioned here that the resection was performed with restraint at the express wish of the patient in order to protect the arytenoid cartilage and avoid a permanent tracheostomy. A further resection would have led to an opening of the pharynx and thus to a laryngectomy, which the patient also refused. In the current R0 situation, suture the right vocal fold anteriorly to improve vocal fold tension and successive hemostasis. Pharyngeal mucosa is visible on the left side, but is intact. Insertion of fibrin glue. Now suture the ligamentum conicum to the thyroid cartilage and insert a Keel. Closure of the prelaryngeal musculature as well as the subcutaneous fatty tissue and skin after insertion of a flap. Now insertion of a nasogastric tube and demonstration of the findings to the anesthesia colleagues. End of the operation. Conclusion: V.a. cT2 cN0 cM0 transglottic laryngeal carcinoma on the left side. Neck dissection on both sides was omitted due to the cN0 neck status after consultation with <CLINICIAN_NAME>. The frozen section showed an R0 resection. The final histology should be awaited and the patient should be presented at the interdisciplinary tumor conference.