Initial consultation with the anesthesiologist. Intubation of the patient by the anesthetist, which is very difficult due to the anatomical situation. Adjustment with the size C small bore tube. There are granulating changes in the area of the larynx due to nicotine abuse and surgery. A definite tumor is no longer recognizable after the tumor was already subtotally removed during the first operation approx. 6 weeks ago. In the area of the former tumor region, in the area of the glottis on the right front, a resection was performed. Careful hemostasis. The surgical procedure is significantly hindered by the patient's very difficult positioning. The patient is alternated between a small bore tube and a size D tube. As far as can be assessed intraoperatively, no tumor can now be detected. A marginal sample is taken from the left anterior region. Extremely difficult procedure. No further measures due to the current situation. Finally, endoscopy of the cervical trachea, glottis, subglottis and supraglottis. No evidence of tumor manifestation on all sides, but overall clearly altered mucosal conditions. Wait for the marginal sample and repeat control microlaryngoendoscopy in approx. 6-8 weeks. No further measures should be taken in view of the patient's overall situation with a very narrow larynx and the risk of edema formation. Final consultation with the anesthesia department. The risk of postoperative edema formation is discussed here in particular. Note: Extremely difficult surgical procedure due to the previous operation and the patient's overall situation and in view of the local findings.