First inspection of the primary tumor region. This revealed a partially ulcerated process of the right edge of the tongue, measuring approx. 2 x 4 cm in total with infiltration of a good 1-1.5 cm in depth; the lateral and posterior floor of the mouth was largely free and regular. There is also no infiltration of the glossotonsillar groove. Good exposure possibility. The tongue is now snared transorally. Incision of the tumor with a safety margin of a good 1 cm, also in the depth of a soft tissue mantle of 1 cm on all sides. Ligation of an arterial and a venous side branch and removal of the tumor macroscopically on all sides in sano, which is thread-marked on all sides for frozen section diagnostics. Here, all margins including the basal margin are diagnosed as tumor- and dysplasia-free, hence a clear R0 situation. Later, after final inspection and wound irrigation, the adapting mucosa is used to compress the wound surface. The lateral floor of the mouth is easily displaceable and there is no penetrating defect, so there is no indication for reconstruction here. Turn to the right side first for neck dissection. Skin incision made at the anterior edge of the sternocleidomastoid muscle, cutting through skin and subcutaneous tissue. Dissection of the platysma, exposure and preservation of the external jugular vein and the auricular nerve. Exposure of the sternocleidomastoid muscle and omohyoid muscle, submandibular gland and digastric muscle. Removal of the anterior neck preparation with careful protection of the facial vein, the superior thyroid artery, the hypoglossal nerve and the cervical nerve. Exposure of the accessorius nerve. Clearing of the accessorius triangle, free preparation of the internal jugular vein with exposure of the external and internal carotid artery, which shows a clear kinking with a lateral course. Exposure of the vagus nerve, clearing of level V with careful protection of the cervical plexus branches. Finally, evacuation of level Ib. Dislocation of the submandibular gland, evacuation of the level with careful protection of the ramus marginalis mandibulae. Final wound inspection and wound irrigation and, if the wound is dry, insertion of a 10-gauge Redon drain and careful two-layer wound closure. Turn to the opposite side. In principle, the same procedure is used here. After exposing and preserving the external jugular vein and auricular nerve, expose the limited musculature. Then remove the anterior neck preparation and preserve the V. facialis, A. thyroidea superior, N. hypoglossus. Exposure of the accessorius nerve, here the vascular tissue is left in place and level IIb is therefore only partially cleared out. Careful dissection of the internal jugular vein. Exposure of the vagus nerve and the course of the internal carotid artery exactly as described on the opposite side. Clear kinking here too. Deposition of the specimen at the transition to level Va with careful protection of the cervical plexus branches. Here too, final wound irrigation and, if the wound is dry, insertion of a 10-gauge Redon drainage and careful two-layer wound closure. Subsequently, as described above, final enoral inspection and, after treatment of the defect, completion of the procedure without any indication of complications. The patient received intraoperative single shot antibiotics with Unacid 3 g. Conclusion: Intraoperative R0 resected cT2 cN2b tongue margin carcinoma on the right. After receiving the definitive histology, presentation at our interdisciplinary tumor conference to determine the adjuvant procedure.