First consultation with the anesthesiologist. Application of local anesthesia in the median neck area. Abjode and cover the surgical area. Skin incision in the median line, running vertically. Exposure of the subcutaneous tissue, exposure of the infrahyoid musculature. Exposure of the linea alba. Dissection of the linea alba. Finding the thyroid cartilage. Finding the cricoid cartilage. Finding the ligamentum conicum. Exposure of the trachea. Exposure of the cervical trachea after transection of the isthmus of the thyroid gland and corresponding ligation. Dissection of the ligamentum conicum. Opening of the thyroid cartilage in the median line. The tumor is visible, which extends from the anterior commissure to the arytenoid cartilage and also just reaches the posterior commissure. The pouch ligament is tumor-free. The tumor extends circumscribed to the ligament, especially in the posterior parts. Careful resection of the tumor, on all sides in healthy tissue. The perichondrium of the thyroid cartilage is detached in the anterior parts. Dorsal dissection. After the arytenoid cartilage has been included in the tumor, partial resection of the arytenoid cartilage, clearly in the healthy tissue, and removal of the tumor. Only parts of the processus muscularis of the arytenoid cartilage remain. Careful hemostasis. Removal of marginal samples at all levels. All marginal samples are found to be tumor-free. An R0 resection can therefore be assumed. Grinding of the thyroid cartilage with the diamond ................... Closure of the larynx with two Vicryl sutures. Reconstruction of the ligamentum conicum. Opening of the trachea between the 2nd and 3rd tracheal ring and creation of a small tracheostoma. Careful hemostasis. Epithelialization of the tracheostoma. Wound closure in layers. Application of a pressure dressing. Completion of the procedure. Final consultation with the anesthetist. Close monitoring is absolutely essential.