First induction of anesthesia and intubation with a laser tube transorally via the anesthesia colleagues. Entry with the Kleinsasser tube and identification of the tumor. This is very difficult as the tumor has been reduced in size by the biopsy and only a scarred area is visible. A sample is therefore taken from this area to ensure that the tumor is resected correctly. The frozen section of this sample shows at least a carinoma in situ and suspected invasive carcinoma matching the preliminary histology and after consultation with the pathology department it is the site described. Therefore, insertion of the DaVinci oral retractor. Insertion of camera and dissection arm and dissector arm. The tumor is now robotically sectioned using monopolar coagulation and the specimen is thread-marked for the frozen section. In the frozen section, there is still invasive tumor in the basal/caudal margin. For this reason, a large resection is made here, thread-marked and also sent to the frozen section. Neither carcinoma in situ nor invasive carcinoma can now be detected at the basal and mucosal margins remote from the tumor, i.e. a definitive R0 situation. Moderate bleeding occurs during the post-resection, which is monopolar coagulated and thus stopped. Due to the relatively large wound area at the base of the tongue, a protective tracheotomy must be performed by <CLINICIAN_NAME>. Skin incision below the cricoid cartilage for this. Dissection down to the trachea. Cut through the thyroid isthmus and enter the trachea between the second and third tracheal cartilage. Creation of a visor tracheotomy. Re-intubation to an 8 mm tracheal cannula and completion of the procedure without complications. The patient goes to the intensive care unit awake for monitoring.