Operators: <CLINICIAN_NAME>, <CLINICIAN_NAME>, guest Initially PEG device. Problem-free entry with the flexible esophagoscope. Under diaphanoscopy after infiltration of local anesthetic, insertion into the stomach with the trocar about 2 transverse fingers below the costal arch. Insertion of the PEG tube in the typical manner. Repositioning for tumor tonsillectomy: The ulcerating tumor described above is seen in the area of the right tonsil lobe, which extends far into the base of the tongue Starting at the upper pole of the tonsil, it is now successively detached from the muscles of the palate with the electric knife. Repeated careful hemostasis using bipolar electrocoagulation. The tumor has infiltrated deep into the muscles at the base of the tongue. The lingual artery and vein must be ligated. The tumor was removed en bloc and a resection was performed in the area of the posterior palatal arch, although macroscopically it was not completely free of tumor. Overall, the tumor was removed with a safety margin of 0.5 to 1 cm. Due to the extensive infiltration into the neck musculature, <CLINICIAN_NAME> decided not to perform a neck dissection at the same time and to wait for stable wound conditions. After waiting for repeated bipolar coagulation towards the base of the tongue, there is hemostasis. Now repositioning for tracheotomy. After infiltration anesthesia of xylocaine with adrenaline 1 % 1:200 000, skin incision about 2 transverse fingers below the cricoid cartilage. Now dissection of the subcutaneous fatty tissue. Division of the prelaryngeal musculature by entering the linea alba. Exposure of the thyroid isthmus and ligation of a large longitudinal vein. This is undermined with the Overholt and severed by clamping two isthmus clamps in the area of the isthmus. Here, the isthmus is sutured and bipolar electrocoagulation is performed again. Entry into the trachea below the 2nd tracheal cartilage. Creation of a caudally pedicled tracheal flap and incision for epithelialization as well as two skin sutures laterally. Problem-free insertion of an 8-gauge ruffled cannula. Now re-inspection of the tumor bed in the area of the oropharynx. There is no bleeding here. This ends the procedure. Overall extensive tumor in the area of the left tonsil lobe with infiltration into the base of the tongue. Temporary placement of a tracheostoma due to the increased risk of secondary bleeding. Neck dissection and, if necessary, resection in the area of the tumor bed should be performed at intervals of about 10 days.