First, after induction and intubation by the anesthesia colleagues, re-inspection with the Kleinsasser tube. Here, entry with the Kleinsasser tube under dental protection. Inconspicuous oral cavity and oropharynx. As described above, there is an exophytic mass in the area of the right hypopharynx, mainly located in the area of the posterior wall and just reaching the lateral wall in the current status. Otherwise no laryngeal affection. The tip of the piriform sinus as well as the anterior wall and the medial wall are tumor-free, so that the initial description of the tumor must be qualified if the tumor is palpably displaceable. With good displacement, good possibility for laser resection. Therefore resection after adjustment of the tumor, microscopically controlled with the 5 Watt CO2 laser, with adequate safety distance. Regular tissue conditions on all sides, even at depth. No growth towards the vascular nerve sheath. The tumor can now be resected macroscopically and palpatorily in depth and to the side completely in sano. In the area of the mucosal level and the submucosal area, completely forming marginal specimens follow; these are described in the frozen section diagnostics as completely free of dysplasia and tumor. Therefore a clear R0 situation. Careful hemostasis using monopolar coagulation and, if the wound is finally dry, proceed to neck dissection. Neck dissection. First to the right side. Skin incision made at the front edge of the sternocleidomastoid muscle. Cut through skin and subcutaneous tissue. Dissection of the platysma. Exposure and preservation of the external jugular vein and auricular nerve. Exposure of the sternocleidomastoid muscle, omohyoid muscle. Exposure of the submandibular gland, including the caudal capsule, and exposure of the digastric muscle. Release of the anterior neck preparation while carefully protecting the facial vein, the superior thyroid artery and the cervical artery. In the area of the lateral pharyngeal wall, no evidence of a penetrating defect. Dissection of the internal jugular vein. Clearing of the accessorius triangle while protecting the nerve and clearing of level V while carefully protecting the cervical plexus branches. Final wound irrigation and, if dry and intact, insertion of a 10 Redon drain and careful two-layer wound closure. Then turn to the opposite side. Exactly the same procedure here. The incision is also made on the anterior edge of the sternocleidomastoid muscle. Exposure of the limiting musculature. Expose the submandibular gland, also taking the caudal capsule with it. Evacuation of level II a to V a while sparing the facial vein, the superior thyroid artery, the cervical sinus, the accessorius nerve and the cervical plexus. Followed by wound irrigation. Insertion of a 10-gauge Redon drain and two-layer wound closure. Macroscopic cervical confirmation of cN0 neck status on both sides. Due to the location of the tumor, <CLINICIAN_NAME> indicated the placement of a PEG. For this purpose, insertion with the flexible esophagogastroscope under laryngoscopic control. Easy to see through to the stomach. However, computed tomography reveals a suspected thoracic stomach with a clear cranial displacement. Nevertheless, with excellent diaphanoscopy, puncture of the stomach and subsequent insertion of the PEG tube using the usual suture pull-through method was successful. Finally, the findings region is adjusted. This shows dry and slim conditions. Completely slender endolarynx, so that the procedure is terminated at this point. Conclusion: Intraoperative R0-resected cT1 cN0 hypopharyngeal carcinoma on the right. Postoperatively, please abstain from food for 7 days, then carefully and gradually build up the diet and after receiving the definitive histology, presentation at our interdisciplinary tumor conference to discuss adjuvant therapy.  