Surgeons: <CLINICIAN_NAME>, <CLINICIAN_NAME> The patient has a histologically confirmed laryngeal carcinoma. The preoperative laryngoscopy shows that the tumor extends supraglottically to the right side of the ary, consuming the laryngeal epiglottis and growing endolaryngeally on the opposite side. A PEG tube is now placed in the typical manner. First insertion with the flexible gastroscope through the esophagus into the stomach. Then diaphanoscopy in the area of the stomach on the left in the area of the left costal arch and then percutaneous puncture and then placement of the trocar and a PEG tube is placed via this in a typical manner using the thread pull-through method. A gastric tube is then placed. Now form an apron flap. This is lifted at the level of the hyoid bone and fixed in place. A neck dissection is then performed on the right. Expose the front edge of the sternocleidomastoid muscle. Exposure of the cervical vascular sheath (common carotid artery, jugular vein, vagus nerve). Caudal of the neck dissection preparation is now dissected cranially for approx. 2 cm. The accessorius nerve is now exposed cranially. The digastric muscle and the hypoglossal nerve are overlaid by a large metastasis, which is carefully removed from the surrounding connective tissue and the jugular tissue. The hypoglossal nerve is then safely identified. The lateral neck dissection specimen is now developed and removed from cranial to caudal while protecting the cervical nerve plexus as much as possible. Now the medial part of the common carotid artery is exposed and the bifurcation is sought out and the external carotid artery is traced further. Identification of the superior thyroid artery. Clamp it, cut it and then ligate it. The medial neck dissection preparation is now completed. Now move to the opposite side. Perform the left neck dissection. Exposure of the anterior edge of the sternocleidomastoid muscle. Caudal exposure of the common carotid artery, the jugular vein and the vagus nerve. The neck dissection specimen is now placed laterally at the level of the omohyoid muscle and developed approx. 2 to 3 cm cranially. The accessorius nerve, the hypoglossal nerve and the digastric muscle are now identified cranially. The lateral neck dissection preparation is now developed from cranial to caudal. The neck dissection is now completed medially and the common carotid artery is shown. The carotid bifurcation is identified. The external carotid artery is further traced with the superior thyroid artery clamped, severed and ligated. The hyoid bone is then sought out and freed from surrounding connective and fatty tissue. The prelaryngeal muscles (sternohyoid and thyrohyoid muscles) are dissected ventrally up to the level of the supraclavicular region. The hyoid bone is then removed in toto. The posterior horn of the thyroid cartilage is then identified. Identification of the vascular nerve bundle (superior laryngeal artery and the vein accompanying the superior laryngeal nerve) are identified on both sides, clamped, severed and ligated. The hypopharynx is then bluntly released from the thyroid cartilage on both sides. The larynx is then mobilized laterally. The tracheotomy is now performed. Identification of the thyroid isthmus. Clamp it and stop it. The trachea is incised transversely at the level of the 3rd/4th tracheal cartilage and the trachea is fixed caudally to the skin. Now enter the pharyngeal tube. Identification of the epiglottis, which is dislocated. This reveals the tumorous infiltration described above. The larynx is now incised along the aryepiglottic fold on the right and left. The two incisions are now joined below the arytenoid region. Now develop the hypopharyngeal tube and tilt the larynx ventrally. The trachea is then cut out cranially in the form of a tongue. Careful hemostasis is then performed. Samples are taken from the edges for frozen section diagnosis (circular incision around the defect and marking of the defect). The frozen section diagnosis does not reveal any evidence of carcinoma infiltration, so that an R0 situation can be assumed in the present case. Placement of TachoComp, followed by suturing of the muscle layer above the pharyngeal tube. The prelaryngeal musculature is readapted. Subsequent careful irrigation of the wound. Placement of Redon drains. Subcutaneous suture. Skin suture. Suturing of the tracheostoma. It is now apparent that there is probably a dermal nevus on the right supraclavicular side, which is incised and sent for histopathological processing. A tracheostomy tube was then placed. The patient is then admitted to the intensive care unit postoperatively. F a c i t : Laryngectomy, neck dissection on both sides for cT3 laryngeal carcinoma on the right. After receiving the histology, the patient should be presented to the interdisciplinary tumor conference for evaluation of postoperative radiotherapy or radiochemotherapy.