First, induction of anesthesia and transoral endotracheal intubation by the anesthesia colleagues and positioning of the patient by the surgeon. Laryngoscopy is performed using the Kleinsasser C-tube. Adjustment of the endolaryngeal findings. This reveals an exophytic mass affecting the anterior and middle third of the right vocal fold, the entire anterior commissure and the anterior third of the left vocal fold, without narrowing of the glottis lumen. The supraglottis and the subglottis are not affected by the tumor. Therefore, due to the massive involvement of the anterior commissure, the decision was made to proceed transcervically. Skin spray disinfection. Application of local anesthesia in a skin fold directly at the level of the thyroid cartilage. Skin ablation and sterile draping. Horizontal skin incision. Separation of the subcutaneous tissue and the platysma. Formation of a subplatysmal flap up to the thyroid incisura and caudally to the cricoid cartilage. Exposure of the anterior jugular vein with its branches. Ligation of the same. Exposure of the surface of the thyroid cartilage. Exposure of the ligamentum cornicum and the bovine cartilage. First transverse incision of the corniculate ligament. Followed by a paramedian scalpel incision on the left side along the surface of the thyroid cartilage. Dissection of a perichondrium flap on both sides. Subsequent paramedian thyrotomy using a wheel and entering the endolaryngeal lumen from cranial to caudal. Dissection of the endolaryngeal soft tissue and visualization of the tumorous findings. First enter the correct subperichondrial layer. Inclusion of the endochondrium in the tumor preparation on the right side. It is then possible to remove the tumor on the right in toto. Hemostasis there using bipolar coagulation and removal of the following marginal samples on the right: subglottis on the right, anterior commissure on the right, supraglottis on the right, posteriorly towards the arytenoid cartilage on the right. Identical procedure on the left side. Inclusion of the anterior endochondrium in the tumor specimen. Resection of the specimen in toto. Removal of the following marginal samples: left subglottis, left anterior commissure, left supraglottis, posteriorly towards the left arytenoid cartilage. All eight marginal samples were found to be tumor-free by the pathology colleagues. Endolaryngeal hemostasis using bipolar coagulation and suprarenin-impregnated pointed swabs. Subsequent suture adaptation of the cornic ligament. Adaptation of a size 16 Keel placeholder after drilling holes in the thyroid cartilage. Subsequent suture adaptation of the prelaryngeal musculature in the midline. Creation of a flap. Platysma suture. Single button skin suture. Application of a steristrip dressing and a pressure bandage. Subsequent placement of a nasogastric feeding tube without any problems and completion of the procedure without complications. The patient received intraoperative Clindamycin 600 mg intravenously, which should be continued for the next 5 days. Nutrition via the nasogastric feeding tube should also be continued for a further 5 days. Please plan a control MLE and, if necessary, Keel removal in 6 weeks.