First alcohol disinfection. Application of local anesthesia. Apron-like skin incision. Subcutaneous preparation. Neck dissection is then performed on the left side. To do this, first expose the internal jugular vein, the accessorius nerve, the digastric muscle, the vagus nerve, the external and internal carotid artery. Then successive development of the lateral neck preparation while sparing the above-mentioned structures. Development of the medial neck preparation, also sparing the above-mentioned structures. Now repositioning for neck dissection on the right side. Infiltration, at least of the internal jugular vein. For this reason, the cranial and caudal ends of the internal jugular vein are exposed first. This is ligated. Then visualization of the accessorius nerve and the digastric muscle. Here it is already suspected that the accessor nerve is infiltrated by a large lymph node metastasis. This also infiltrates the sternocleidomastoid muscle. The tumor block is now dissected laterally from the medial side along the external and internal carotid artery. During further dissection and visualization of the vagus nerve, this is also infiltrated at approximately the level of the carotid bifurcation and is therefore included. The tumor or neck preparation is then developed and removed, taking parts of the sternocleidomastoid muscle with it and partially taking the omohyoid muscle with it. Careful hemostasis, left and right. Now development of the larynx preparation. To do this, first expose the hyoid bone and the thyroid cartilage. Separation of the pharyngeal muscles from the thyroid cartilage on both sides. A tracheotomy is then performed beforehand. This involves cutting through the thyroid isthmus. This is stitched and then a tracheotomy is performed between the 2nd and 3rd tracheal clasp. First incision of the caudal skin flap. Further development of the LE preparation. For this purpose, release of the piriform sinus on both sides. Then release the epiglottis at the free edge of the epiglottis. Then entering the pharyngeal tube and successive excision of the laryngeal preparation along the aryepiglottic fold. Incision united posteriorly postcricoidally. Detachment of the postcricoid mucosa, which is not affected by the cricoid cartilage plate. Further detachment of the laryngeal preparation. Separation in the area of the trachea and removal of the entire preparation for frozen section diagnostics. The edges of the incision are found to be tumor-free. Now rinse thoroughly. Cut through the pharyngeal muscles or the esophageal sphincter. Insertion of a Provox prosthesis 4 to 5 mm above the edge of the tracheal incision. This is successful without any problems. Then multi-layered, inverting pharyngeal suture. Readaptation of the infrahyoid muscles at the hyoid bone after subtle hemostasis has been performed. Now suturing of the tracheostoma and skin after insertion of 2 Redon drains, one on the left and one on the right. Multi-layer wound closure. Completion of the procedure.