Introductory consultation with the anesthesia department. After appropriate preparation, skin disinfection and sterile washing. Marking and incision of the apron flap. Dissection cranially up to above the hyoid bone. Then perform the neck dissection on the right side. Skeletonization of the sternocleidomastoid muscle and displacement, neurolysis and re-embedding of the accessorius and hypoglossal nerves. Subsequently, clearing of regions II to IV with preservation of all non-lymphatic structures and dissection of the internal jugular vein and carotid artery. Subsequent exposure of the lateral hyoid horn and release of the infrahyoid muscles with exposure of the thyrohyoid membrane. Skeletonization of the common carotid artery and external carotid artery with exposure of the superior thyroid artery, along which the right thyroid lobe can also be separated from the laryngeal skeleton and displaced laterally. Cut and separate the straight prelaryngeal and prethyroid muscles. Subsequently undermine the thyroid isthmus down to the pretracheal lamina, clamp the isthmus so that the upper six tracheal clasps are fully exposed. Then sharply separate the insertions of the constrictor pharyngis muscle at the edge of the thyroid cartilage and release the piriform sinus on this side. Then transition to the opposite side. In principle, the procedure is the same here with the same findings. Perform the tracheotomy. Opening of the trachea under the 2nd tracheal clasp. Re-intubation of the patient. This is followed by a total laryngectomy. The lingual surface of the epiglottis is exposed up to the upper edge and the mucosa is only incised at the upper edge of the epiglottis. This allows it to be disluxed and the larynx to be removed along the epiglottis and finally postcricoidally. The protrusion of the left-dorsal tumor in the area of the cricoid cartilage can also be seen here, although it remains covered by intact mucosa or muscle tissue. The larynx is then released together with the two upper tracheal clips. Removal of a marginal sample from the caudal resection margin of the specimen towards the trachea as well as from retrolaryngeal tissue in the area of the tumour location. Both histologies prove to be tumor-free in frozen section diagnostics. The pars membranacea of the trachea is then mobilized so that it can be mobilized cranially to complete the mucocutaneous anastomosis. Perform the voice prosthesis puncture with insertion of a size 8 Provox Vega voice prosthesis at the upper edge of the tracheostoma. Perform a myotomy of the constrictor pharyngis muscle. The pharyngeal suture is then applied. The first layer forms a continuous Conley suture. An additional wound closure is made using the single-button technique. Insertion of the Redon suction drains on both sides. Folding back the apron flap. Completion of the mucocutaneous anastomosis of the tracheostoma and double-layered suturing of the lateral wound edges. Finally, easy transfer of the patient to a 10-gauge Rügheimer cannula. Sterile wound dressing. Application of a pressure dressing. Final consultation with the anesthetist. Conclusion: Total laryngectomy with selective neck dissection on both sides. Primary voice rehabilitation by implantation of a Provox Vega 8 mm voice prosthesis with myotomy of the constrictor pharyngis muscle.