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. Transition to tracheoscopy: problem-free passage of the non-irritated glottis and endotracheal entry. Mucosal conditions are normal on all sides up to the tracheal bifurcation. Intubation of the patient. Transition to esophagogastroscopy: insertion of the endoscope under visualization and constant air insufflation into the stomach. Insufflation of the same. This reveals a typical gastric mucosal relief without irritation on all sides. Occasionally, small, broad-based polyps can be seen in the area of the large curvature. Inversion and inspection of the gastroesophageal junction. This appears to be altered in a reflux-like manner. After desufflation, slow withdrawal of the endoscope with circular inspection of all sections of the esophagus. This reveals leukoplakic-like changes to the mucosa, particularly in the distal and cervical sections, which cannot be flushed away. Both the gastric polyps and the esophageal findings should be checked gastroenterologically at intervals. Then insert the mouth guard and enter with the size C small bore tube. Adjustment of the endolarynx. Mucosal conditions are normal on all sides. Enter the piriform sinus on both sides. This is lined with smooth mucosa on all sides and can be seen freely up to the tip of the piriform sinus. There is also no evidence of a tumor postcricoidally or in the area of the esophageal opening. Adjustment of the findings described above using the McIvor oral spatula. This shows the exophytically growing mass in the area of the left soft palate. The main tumor mass appears to be localized on the posterior surface of the velum. Medially, the tumor growth extends over the posterior surface across the base of the uvula to the opposite right side, where it only reaches the anterior palatal arch. Laterally to the left, the tumor extends macroscopically to the upper tonsil pole. Velotractio is applied in the typical manner and the posterior surface of the velum is inspected. The tubes appear free on both sides. The tumor does not extend very far cranially on the posterior surface of the velum. Hence the decision to resect the tumor. As the tumor grows macroscopically on the posterior surface of the uvula to the opposite right side, the decision is made to resect the uvula completely. Starting parauvularly on the right and resection of the tumor with an electric needle and pointed scissors. The tumor can thus be exposed well and resected macroscopically in sano. In the area of the anterior palatal arch on the left side, a resection specimen is taken with macroscopically close in sano resection. The main specimen is thread-marked at the corresponding site. A biopsy is also taken in the area of the left caudal tonsil lobe. The mucosa here also appears to be leukoplakically altered. Hemostasis by means of bipolar coagulation and insertion of H2O2-soaked ball swabs. If the wound bed is dry, the operation is completed without complications. Final consultation with the anesthesiologist. Due to the growth crossing the midline, a neck dissection should be planned on both sides during the inpatient stay. The placement of a PEG feeding tube was deliberately avoided for the time being.