Induction of anesthesia by the anesthesia colleagues, then entry with 0° optics and inspection of the larynx. There is an exophytic mass in the area of the epiglottis, aryepiglottic fold, vocal folds on both sides, especially in the postcricoid region. The tumor extends ˝ cm into the subglottic slope. Then intubation by the anesthesiologist and repositioning for laryngoscopy. Entry with the small bore tube and inspection of the larynx. An exophytic mass is seen, starting from the left pocket fold with transition to the vocal folds, then transition to the arytenoid cartilage and infiltration of the postcricoid region and the arytenoid cartilage on the right side. The tumor also extends into the medial wall of the piriform sinus on the left side and into the aryepiglottic fold and the laryngeal surface of the epiglottis. The tip of the piriform sinus on the left side is free. The piriform sinus on the right side is completely free. The posterior pharyngeal wall is also free. Then insertion of a nasogastric tube and repositioning for esophagogastroscopy and insertion of a PEG using the thread pull-through method. With good diaphanoscopy, this can be done without any problems. Sterile washing and draping. Placement of an apron flap in the usual manner. Repositioning and beginning on the right side with exposure of the sternocleidomastoid muscle, the omohyoid muscle, the digaster and the submandibular gland. Then exposure of the cervical vascular sheath. Detachment of the cervical vascular sheath from the larynx. Skeletonization of the larynx by exposing the hyoid bone and detaching the infrahyoid musculature. In the area of the larynx itself, muscles and soft tissue are left on the thyroid cartilage. Detachment of the thyroid gland and transection of the laryngeal artery, laryngeal vein and superior laryngeal nerve. Same procedure on the left side. Then perform the tracheotomy. To do this, cut through the thyroid isthmus and expose the anterior wall of the trachea. Insertion between the 3rd and 4th tracheal cartilage due to subglottic thinning. Then release of the hyoid bone and release of the piriform sinus on the right side of the thyroid cartilage. Then release of the piriform sinus, as far as possible, also on the left side. Then enter the pharynx above the hyoid bone. Pull out the epiglottis and inspect the tumor, which appears as described above. Cut along the epiglottis on the right side. Incision of the postcricoid region first on the right side, sparing the piriform sinus, then on the left side, where part of the piriform sinus must be removed in order to resect the tumor completely. Then detachment of the larynx from the esophageal entrance and removal of the larynx below the cricoid cartilage. The entire laryngeal preparation is thread-marked for frozen section. In the area of the piriform sinus entrance medial wall, a resection and a marginal specimen of the same name are taken. The marginal specimen and the laryngeal preparation are designated as R0 in the frozen section. In the meantime, perform the neck dissection, initially on the left side. The sternocleidomastoid muscle, the digaster muscle, the omohyoid muscle, the submandibular gland, the cervical vascular sheath and the accessorius nerve are exposed. Then release of the neck preparation II a to V a, sparing the plexus branches and repositioning for neck dissection on the right side by <CLINICIAN_NAME>. Here also completion of the exposure of the neck borders of the sternocleidomastoid muscle, submandibular gland, omohyoid muscle, digaster muscle and accessor nerve, free preparation of the jugular vein and release of the neck preparation II a to V a, while sparing the plexus branches. Insertion of a Provox voice valve prosthesis in the usual manner. Provox size 6. Then the pharyngeal suture is performed in the usual manner, in two layers with single button sutures and the third layer adaptation of the pharyngeal muscles. The thyroid gland is very enlarged on both sides and is not sutured over the pharynx. The insertion of the sternocleidomastoid muscle is then reduced on both sides to achieve a flat stoma. Insertion of 2 Redon drainage tubes and suturing of the tracheostoma in the upper area. Two-layer wound closure and insertion of a 10 mm tracheostomy tube. The patient goes to the intensive care unit intubated and ventilated. Please continue antibiotics for 24 hours. X-ray gruel swallow on the 10th postoperative day, then, if there is no fistula, please resume diet.