After appropriate preparation, first perform the tracheostomy. Incision of the trachea below the third tracheal clasp and insertion of the tube after reintubation of the patient. Subsequent infiltration with local anesthetic containing adrenaline in the area of the subsequent apron flap incision. Sterile washing and draping. Sharp formation of the apron flap subplatysmal and elevation and fixation upwards in the usual manner to beyond the hyoid bone. Now start with the neck dissection on the right side. Mobilize the sternocleidomastoid muscle while protecting the medial and lateral parts of the accessorius nerve. Exposure of the digastric muscle. Opening of the vascular nerve sheath and skeletonization of the internal jugular vein and the carotid artery. Regions II to V are then removed, sparing all non-lymphatic structures. Subsequently, the superior thyroid artery is ligated,.............. Hypoglossus. Now detach the constrictor pharyngis muscle from the thyroid cartilage. Release the piriform sinus. Separation of the prelaryngeal and prethyroid muscles and lateral displacement of the right thyroid lobe. Subsequent transition to the opposite side. Similar procedure with the same findings. A suspicious lymph node metastasis is found macroscopically in the area of the facial angle, which is of course also removed. After appropriate mobilization of the larynx, an incision is made at the lower edge of the cricoid cartilage. Dissection of a caudally pedicled mucosal flap, which is used to cover the tracheal chimney, in the usual way. Then dissect the larynx cranially. Enter the hypopharynx at the level of the arytenoid cartilage. Widen the incision to the right to ensure a good view of the tumor, which is mainly located on the left. The tumor is then released with a macroscopic safety margin of 0.5 to 1 cm. Cranially, parts of the vallecula and the base of the tongue are included in the resection. On subsequent inspection of the resected area, the impression is gained that the safety margin is somewhat smaller in the caudal resection area, both on the right and left. Therefore, resections are performed on both sides. The resulting mucosal defect is then circumcised and all specimens are sent for frozen section histological examination. These proved to be tumor-free. Only postcricoidal moderate dysplasia was found. Therefore, a resection and a further frozen section for normal histology are performed at this point. Subsequently, myotomy of the inferior constrictor muscle on the dorsal side of the hypopharynx. Insertion of a size 8 Provox Vega8 cannula. Completion of the tracheostoma by H-shaped incision of the third tracheal clasp and completion of the mucocutaneous anastomosis. Subsequent two-layer closure of the mucosal defect in a T-shape. The first layer contains an inverting continuous suture according to Conley. The second layer consists of the surrounding muscle tissue using a single button suture. Finally, three Redon drains are inserted on each side of the neck. Folding back the apron flap and two-layer wound closure with continuous skin suture by <CLINICIAN_NAME>. Re-intubation of the patient onto a 10 mm tracheal cannula. Sterile wound dressing. End of the operation. Handover of the patient to anesthesia. Conclusion: Total laryngectomy with selective neck dissection of regions II to V on both sides, for supraglottic laryngeal carcinoma. Primary voice rehabilitation by insertion of a size 8 Provox-Vega prosthesis and myotomy of the contrictor pharyngis muscle. Insertion of a tracheal chimney according to Herrmann. Please carry out a postoperative X-ray broad swallow on the 7th to 10th day. If a fistula is excluded, removal of the gastric tube and start of oral nutrition and phonation.  