After tracheoscopy during intubation, panendoscopy of the oropharynx and finally esophagoscopy were performed: Apart from the hypopharyngeal carcinoma on the left side described above, no other lesion was found. The tumor originates from the medial hypopharyngeal wall, just extending laterally onto the arytenoid hump, but neither affecting the interary region nor the postcricoid. Laterally, the tumor extends in the entrance of the piriform recess along the anterior wall and just reaches the lateral side wall. The tumor is quite easy to move with the suction cup, in particular there is mobility towards the arytenoid cusp on the left. A deep infiltration of the cusp does not appear to be present here. The vocal cords are also clinically mobile on both sides. A PEG tube is inserted as part of the final esophagoscopy. The left-sided hypopharyngeal tumor is then adjusted with the Steiner tube. Adjustability is good. The tumor is then completely ablated with the CO2 laser under microscopic vision. The safety margin is at least 0.5 cm. The tumor can be easily removed from the deep layers, especially from the arytenoid cusp, in healthy tissue. Nevertheless, a final resection is taken from the left arytenoid hump and sent for final histology. Careful hemostasis. This is followed by repositioning for neck dissection, first on the left: For this, skin incision in a skin fold, 2 to 3 transverse fingers submandibularly. After skin incision, dissection of the subcutaneous tissue and exposure of the platysmal flap. Creation of platysmal flaps caudally and cranially. Dissection of the anterior edge of the sternocleidomastoid to the vascular nerve sheath. Expose the posterior venter of the digastric muscle cranially. Dissection now along the omohyoid muscle from distal to proximal to the hyoid bone. Dissection of the lower edge of the submandibular gland and completion of the neck resectate to the hyoid bone. Dissection along the posterior digastric venter muscle to the base of the skull and subsequent dissection of the internal jugular vein. The dissection reveals numerous conspicuous lymph nodes. Level IIb and Va in particular show pronounced lymph node involvement. All vascular nerve structures were spared during the dissection. After elevation of regions II, III and IV, level 5 is completely elevated while sparing the plexus and the accessorius nerve. Subsequent neck dissection on the right side: The same procedure is used here with a corresponding skin incision 2 to 3 transverse fingers submandibularly. Creation of cranial and caudal platysmal flaps and dissection of the vascular nerve sheath by exposing the anterior edge of the sternocleidomastoid. Dissection along the omohyoid muscle up to the hyoid bone and along the posterior digastric venter muscle in the cranial region. Dissection along the internal jugular vein and also here elevation of the neck block in regions II, III and IV. Conspicuous nodes are found particularly in level IIb. Finally, also sparing the accessorius nerve and the cervical plexus, elevation of level V. Careful hemostasis on both sides. Insertion of 10 Redon drains on both sides, subcutaneous sutures and skin sutures on both sides. Sterile wound dressing.