After active patient identification, transfer the patient to the operating room. Carry out the team time out. Induction of anesthesia and intubation by the anesthesia colleagues. Then, together with <CLINICIAN_NAME>, determination of the resection margins on the left edge of the tongue. Then insertion of the blocker and tongue suture. The tumor is now excised with the electric needle with a safety margin of at least 0.5 cm and a depth of 1 cm in the muscular area. This creates a relatively large wound area. Intermediate bipolar hemostasis. This resectate is then thread-marked for final histology. Now take marginal samples, on the one hand from the anterior and posterior tongue surface with respective suture marking and on the lower surface at the transition to the floor of the mouth in one piece and in triplicate from the wound bed anteriorly, medially and posteriorly. The samples are all classified as tumor-free in the frozen section. Therefore, bipolar hemostasis and insertion of a Tranexam-soaked compress. Transition to neck dissection on the left side. Placement of facial nerve monitoring. Abjoration and sterile draping. The skin incision is made in a skin fold approx. 2 cm from the mandible and is curved slightly upwards posteriorly and also curved slightly submentally anteriorly in order to access level Ia. Dissection through the subcutaneous tissue and through the platysma. The platysma flap is then formed cranially and caudally. Cranially to just below the marginal ramus, which can be detected with stimulation. Then dissect the sternocleidomastoid muscle as well as the digaster venter anterior muscle and omohyoid muscle. Exposure and protection of the accessorius nerve. Protection of the cervical profunda. Protection of the marginal ramus. Dissection of the internal jugular vein and the facial vein, all of which are preserved. Subsequent dissection of level II b and the lateral compartment. Subsequent dissection of the anterior neck compartment. Now expose the submandibular gland and move it upwards. The marginal ramus is spared up to the anterior. It can still be stimulated proximally at the end of the operation. Exposure of the mylohyoid muscle and the digaster venter muscle anteriorly on both sides. Clearing of level I b and I a. Protection of the hypoglossal nerve. Subsequent subtle hemostasis with H2O2 and Ringer and bipolar coagulation. Placement of a 10 Redon drain, subcutaneous and platysma suture with 4-0 Vicryl and skin suture with 5-0 Ethilon. Subsequent final enoral check. The wound edges are slightly adapted posteriorly and anteriorly with 2 Vicryl 3-0 SH sutures. A relatively large wound area remains. Repeated subtle bipolar hemostasis and completion of the operation at this point without complications. Conclusion: Enormous tumor resection in cT1 cN0 tongue margin carcinoma on the left, tumor-free in the frozen section. Neck dissection level I a to IV left.