Initial head positioning by the surgeon. Insertion of the McIVOR oral spatula and adjustment of the left tonsil tube. Macroscopically inconspicuous .............. Tonsil, in particular no evidence of growth of the suspected carcinoma beyond the tonsil on inspection. Marking of the resection margins in the area of the anterior and posterior palatal arch using a monopolar needle. Tumor tonsillectomy is then performed using the dissection technique, including a muscle margin of the palatoglossal arch and parts of the anterior and posterior palatal arch and the base of the tongue in the area of the lower pole. The tonsil is extirpated in toto and sent to the frozen section marked with a suture. The diagnosis of a squamous cell carcinoma resected in sano, but only just R0 towards the base of the wound. In the meantime, head repositioning for neck dissection on the left. After lymph node extirpation in level II on the left, approx. 1.5 transverse fingers wide and thus relatively far superior, a horizontal scar is seen. An attempt is initially made to integrate this into the course of the neck dissection, but this is too close to the lower jaw and would also result in a cosmetically unfavorable, very anterior course of the further incision. It was therefore decided to make a new incision in this area, far posterior to the posterior edge of the sternocleidomastoid muscle. Injection of a total of 8 ml xylocaine with added adrenaline. Skin disinfection and sterile draping. Skin incision down to the platysma. Exposure and ligation of the external jugular vein. Subsequent dissection of the sternocleidomastoid muscle and exposure and protection of the accessorius nerve. Caudal dissection and exposure of the omohyoid muscle. Superiorly, the digaster muscle is exposed through the scar tissue and dissected about halfway anteriorly. Condition after previous operation, difficult conditions. Now dissect the vascular nerve sheath. The neck dissect is dissected in one piece up to level IIa, set down cranially in level IIa, cut caudally under the accessorius nerve. The cervical anus is then located and dissected from inferior to superior and laterally, with successive clean dissection of the neck dissectate from the scalene musculature while protecting the anus. This is successful without any problems. Now caudally, at the end of level IV, separation of the neck dissectate after bipolar coagulation and ligation. Now, after anterior dissection of the outlet of the facial vein and the angle between the facial vein and the internal jugular vein. Dissection of a further lymph node and a small amount of fatty tissue. Subsequent wound irrigation and meticulous hemostasis using bipolar coagulation. There is no evidence of residual fatty tissue or lymphatic tissue in the surgical area. Therefore, insertion of a 10 Redon drain and two-layer wound closure in the typical manner. Head repositioning in the reclination position and insertion of the McIVOR oral spatula. Adjustment of the left tonsil lodge and removal of a total of five marginal samples, which are sent for frozen section. Minute hemostasis using bipolar coagulation. By <CLINICIAN_NAME>, prophylactic caudal and lateral repositioning in the tonsil bed. All marginal samples were found to be tumor-free by the pathology colleagues. Thus repeated inspection. Dry conditions. Removal of the inserted ball swab. Insertion of a nasogastric feeding tube, under visualization in the typical manner. Completion of the procedure without complications.