First, pharyngoscopy again: The tumor is visible, which is essentially limited to the tonsillar lobe or just exceeds it at ........ This is followed by transoral tumor resection: The tumor is removed macroscopically on all sides with a safety margin of approx. 1 cm in healthy tissue. Parts of the pharyngeal musculature are resected as well as parts of the base of the tongue. The specimen is marked for frozen section. Tumor-free at all edges, minimally approx. 3 mm even in the shrunken state, thus R0 resection. This is followed by PEG insertion: insertion of the flexible esophagoscope into the stomach. Insertion of a 15 mm abdominal wall tube in the typical manner without any problems. Fixation to the abdominal wall. Subsequent repositioning for neck dissection on both sides, beginning with neck dissection on the right: here, a 4 cm large lymph node metastasis in level 2 cranial was already diagnosed sonographically. This is followed by the skin incision in front of the sternocleidomastoid muscle. Exposure of the omohyoid muscle and the digastric muscle. Exposure of the cervical vascular sheath, internal jugular vein, internal carotid artery, external carotid artery and vagus nerve. Visualization of the anterior hypoglossal nerve, cranially the metastasis is visible, which is connected to the surrounding soft tissue. Detachment of the accessorius nerve is difficult. Infiltration in particular. Here with resection of the nerve for oncological reasons. Then develop the lateral neck preparation while exposing and preserving the branches of the cervical plexus. Then development of the anterior neck preparation with visualization and preservation of the hypoglossal nerve and superior thyroid artery. This results in a level 2-5 evacuation on the right side. Neck dissection on the left. Operators: <CLINICIAN_NAME>, <CLINICIAN_NAME> alternating Slightly curved incision cervically on the left along the anterior border of the sternocleidomastoid muscle, cutting through the subcutaneous tissue, the platysma, exposing the anterior border of the sternocleidomastoid muscle. Exposure of the omohyoid and digaster muscle, exposure of the accessorius nerve. A conglomerate of lymph nodes is visible in the region of region 2a, highly visible. This is carefully removed while protecting the above-mentioned structures. Exposure of the cervical vascular sheath. Dissection along the internal jugular vein from caudal to cranial. Dissection and removal of the posterior neck preparation. Exposure of the hypoglossal nerve, preparation and separation of the anterior neck preparation. Hemostasis using bipolar coagulation. Irrigation of the wound with hydrogen peroxide and Ringer's solution. Repeated inspection. Placement of a 10-gauge Redon drain. Two-layer wound closure. Completion of the procedure.