After active patient identification, the patient is brought into the operating theater. Carry out the team time-out. Introductory consultation with the anesthesia colleagues. Orotracheal intubation by the anesthesia colleagues using GlideScope optics. Fixation of the tube. Positioning of the patient in head reclination. Skin spray disinfection and infiltration anesthesia. Skin wipe disinfection and sterile draping. First mark the landmarks and the planned incision using the typical broken-line technique. Sharp cutting of the cutis as well as the subcutis. Dissection of the prelaryngeal musculature. Locating the linea alba. Blunt lateralization of the prelaryngeal musculature on both sides. Exposure of the laryngeal skeleton. Finding and exposing the cricothyroid ligament. Horizontal incision of the same. Subsequent paramedian incision of the perichondrium of the thyroid cartilage. Dissection of a typical perichondrium flap. Using the wheel, the larynx is now opened in the median line in the sense of a thyrofissure. Opening of the endolarynx in the median line. Insertion of the small retractor. An extensive, verrucous, tumorous process can now be seen, which encompasses the entire left vocal fold. The tumorous formation extends caudally into the subglottic appendix. Cranially, the tumor grows into the Morgagnian ventricle. The anterior commissure appears clinically tumor-free. Dorsally, the tumor growth extends at least as far as the vocal process. Circular resection of the tumor is now performed while maintaining the corresponding resection margins. In the ventral, cranial and caudal areas, the tumour can be mobilized relatively easily. Here, the resection is carried out with the vocalis muscle. In the dorsal parts, resection is somewhat more difficult. After appropriate oxygenation of the patient, the tube is retracted to ensure a better overview. The tumor is now removed in toto, taking the vocal process with it. Circular margin samples are taken and sent for frozen section diagnostics. In the area of the superior/posterior margin, i.e. in the area of the arys, there are still extensions of a carcinoma in situ. Therefore, the first step is to take the corresponding resected specimens and new margin samples in the two localizations mentioned above (superior/posterior and left arytenoid). As part of the intraoperative frozen section diagnostics, the second margin samples are evaluated as tumor-free. Only moderate dysplasia is detected here, with no evidence of carcinoma in situ. Meticulous hemostasis using bipolar coagulation. Creation of a total of four drill holes in the area of the thyroid cartilage. Removal of the retractor. Adaptation of the thyroid cartilage in the median line using PDS 4.0. Stitching over the incision in the area of the ligamentum conicum. Suturing of the previously prepared perichondrium flap. Readaptation of the prelaryngeal musculature in the median line. A sterile flap was inserted beforehand. Subcutaneous suture with 4.0 Vicryl and skin suture with Ethilon 5.0. Application of a wound dressing and completion of the operation without complications. Final consultation with anesthesia colleagues.