Transfer of the patient to the operating room. Carrying out the team time-out after active patient identification and initial consultation with the anesthesia colleagues. Induction of intubation anesthesia, bronchoscopically by the colleagues. Head positioning by the surgeon. Insertion of the spandex lip retractor and the covered retractor to open the mouth. Inspection of the oropharynx. In the previously described location in the area of the glossotonsillar groove on the left side, a tumor-suspicious ulcer can be seen with slight irregularity of the mucosa. The ulcer extends to the lateral wall of the oropharynx just below the upper pole of the tonsil. Extension of the ulcer of 0.5 x 0.5 cm. In addition, the lateral oropharyngeal wall is palpable. In addition, a palpable mass below the ulcer extending into the base of the tongue. It is decided to incise the area extensively with a safety margin of one cm. To do this, first make an incision in the area of the base of the tongue and carefully dissect with the ultracision knife. The preparation is made in healthy muscles. Dissection is carried out under constant coagulation of small blood vessels and palpatory control. Now also dissection laterally down to the lower jaw. Healthy tissue can be left on the lower jaw so that no bone is exposed. During dissection, the lingual nerve is exposed, which is looped and moved laterally. Now also detach the tumor from the cranial tonsil pole. Here, entry in the area of the anterior palatal arch and dissection of the tonsillar lobe. Incision of the posterior palatal arch and careful pushing of the resectate from the lateral oropharyngeal side wall. This exposes the parapharyngeal vessels, which are safely spared and dissected away from the tumor. A branch of the lingual artery is clipped. After removal of the tumor in the area of the base of the tongue, the lingual artery is exposed over a distance of approx. one cm. The resectate is then placed on the cork plate, marked with a needle and sent for a frozen section histological examination. After feedback from the pathology colleagues, the status is R0 with free resection margins. Bipolar hemostasis of several smaller bleedings in the area of the base of the tongue and the lateral oropharyngeal side wall is performed. The lateral oropharyngeal side wall is sutured over for vascular protection. In addition, wound adaptation of the edges of the tongue and base of tongue to cover the lingual artery. Due to the risk of bleeding, in consultation with <CLINICIAN_NAME>, it was decided to create a protective tracheostoma. After tumor resection as described above, a protective tracheostoma is created. Repositioning and covering the patient. Marking of the thyroid cartilage, cricoid cartilage and jugulum. Easy palpation of the most important structures is possible. Now make a skin incision approx. 2 1/2 cm long and approx. 1 QF wide below the cricoid cartilage. Further dissection in depth with bipolar coagulation of the subcutaneous fatty tissue. Strict dissection along the median line through the prelaryngeal musculature. Intermittent bipolar coagulation of smaller vessels, now exposing the thyroid level. Undermining of the thyroid isthmus from cranial to caudal using a curved clamp, followed by extensive bipolar coagulation of the isthmus and transection using scissors. Blunt dissection and exposure of the trachea. Locate the area between the 2nd and 3rd cartilage clasp. Bipolar marking here for later incision. Now carefully open the trachea using pointed scissors, taking great care not to damage the cuff. Now create the anastomosis between the skin and trachea in the conventional manner. For this purpose, back-stitch suture using Vicryl 4.0 at two points caudally and cranially, laterally in each case. This is successful without any problems, resulting in an epithelialized tracheostoma. Withdrawal of the tube through the anesthesia and problem-free insertion of a size 8 tracheostomy tube. Subsequent intubation without complications and application of a wound dressing. The operation was completed under dry wound conditions. Summary: R0 resection of a cT1 cN0 oropharyngeal carcinoma in the area of the glossotonsillar groove on the left side. The resection margins are all tumor-free in the frozen section. Please present the case at our interdisciplinary tumor conference. Nutrition for 6 days via nasogastric tube.