After induction of anesthesia and intubation by the anesthetist, a microlaryngoscopy is performed first. Here the verrucous carcinoma of the entire left vocal fold can be confirmed. On the right, the findings are limited to the anterior third of the left vocal fold. Now setting with the Kleinsasser C-tube. Start resection with the CO2 laser at 3 watts in the posterior region, directly at the border with the vocal process of the arytenoid cartilage. Then also partial resection of the pocket fold on the left side. The resection extends well into the subglottic area. Approximately 5 mm in front of the anterior commissure, the first part of the tumor preparation is resected. This is followed by repositioning with the Kleinsasser D-tube and removal of the remaining tumor up to the anterior commissure. The thyroid cartilage is resected from its inner side together with the perichondrium in this area. Hemostasis by means of monopolar coagulation, using the forceps and the suction cup. Now turn to the right side. Here there is a much less exophytic aspect, but more a restless mucosa, which is why a partial chordectomy is performed here, leaving parts of the ligament and the vocalis muscle intact. This extends approximately 8 mm posteriorly. After complete resection with the laser, the frozen section diagnosis is performed. Two strips are taken from the right side, one cranial and one caudal, and from the left side one anterior, one caudal and one posterior. A frozen section in the cranial region is not performed due to the resection of the pocket fold and the resulting large distance to the tumor. The frozen section diagnosis resulted in an R0 resection. After renewed careful hemostasis, the procedure is completed without bleeding and without complications. The patient should be presented at the tumor conference and undergo a follow-up microlaryngoscopy in 8 weeks. In addition, care should be taken to also perform a Dacron foil or Keel system in the event of synechiae of the anterior commissure.