After active patient identification, the patient is brought into the operating theater. Carry out the team time-out. Introductory consultation with the anesthesiologist. Induction of anesthesia. Intubation of the patient. First inspection of the tumor area. This is located in the area of the right-sided base of the tongue and does not extend to the midline. Further tumor extensions run over the glossotonsillar groove onto the anterior palatal arch. Insertion of the mouth retractor according to Jennings. Tongue suture. Insertion of the Bruenings hook. Successive resection of the tumor using the electric needle and pointed scissors under palpatory control. Resection of parts of the anterior palatal arch, the glossotonsillar groove and the base of the tongue. Exposure of smaller branches of the lingual artery. These can be easily coagulated bipolarly. The tumor specimen is then thread-marked (lateral, medial, wound base) for frozen section diagnostics. In the meantime, reposition the patient for neck dissection. First, skin spray disinfection and infiltration anesthesia. Abjode the surgical site and cover it sterilely. Marking of the planned incision in the area of the old scar. Sharp cutting of the cutis and subcutis. Exposure of the front edge of the sternocleidomastoid muscle. Overall, clearly scarred changes due to the previous operation. Exposure of the omohyoid muscle as the caudal border. Exposure of the cervical vascular sheath. The scarred changes make dissection conditions considerably more difficult. Numerous cystic metastases can be seen lateral to the cervical vascular sheath. Cranial dissection. Finding the posterior digastric venter above the scar block. Exposure and protection of the accessorius nerve. Displacement and at the end of the operation re-embedding of the accessory nerve in the sense of a neurolysis. Subsequent attempt to develop the lateral neck preparation. However, it became apparent that the metastatic conglomerate in the area of the venous angle was infiltrating the vein. The decision is therefore made to resect the internal jugular vein. Exposure of the cranial part of the internal jugular vein medial to the digastric muscle. Subsequent exposure of the common carotid artery, the external and internal bifurcation. Exposure and protection of the vagus nerve. Exposure of the hypoglossal nerve. Displacement and, at the end of the operation, re-embedding of the vagus nerve and hypoglossal nerve in the sense of neurolysis. Ligation of the internal jugular vein cranially and caudally. Creation of a second ligature. Dissection of the internal jugular vein. Subsequent removal of the lateral neck specimen together with the attached numerous cystically altered lymph node metastases. The accessorius nerve and the plexus branches are spared. Development of the medial neck preparation. At the end of the operation, meticulous hemostasis using bipolar coagulation. Wound irrigation with H2O2 and Ringer's solution. Insertion of a 10 Redon drain. Subcutaneous suture, skin suture and application of a wound dressing. In the meantime, telephone announcement of the frozen section diagnosis. In the area of the lateral margin in the direction of the anterior palatal arch and the glossotonsillar groove, the tumor is edge-forming. For this reason, appropriate resectates are taken here. At the end of the operation, the tumor is clinically R0. Once again meticulous hemostasis using bipolar coagulation. Final consultation with the anesthesiologist. Completion of the operation without complications.