First, induction of anesthesia and transoral endotracheal intubation using a laser tube by the anesthesia colleagues and positioning of the patient by the surgeon. First, the larynx and pharynx were entered using a Kleinsasser C-tube and the findings were inspected. This revealed an exophytic, slightly exulcerated mass originating from the right aryepiglottic fold, affecting the cranial part of the medial wall of the right piriform sinus, clearly infiltrating the anterior wall of the right piriform sinus, but sparing the lateral wall of the piriform sinus as well as the esophageal entrance and the posterior wall of the hypopharynx. Thus V.a. cT2 hypopharyngeal carcinoma on the right side. Setting the CO2 laser to a power of 6 watts in continuous mode. Avoidance of the lesion and problem-free resection of the lesion using a piecemeal technique. Hemostasis using monopolar coagulation. Subsequently, 4 marginal samples were taken (right aryepiglottic fold, anterior wall of the piriform sinus, lateral wall of the piriform sinus, caudal area of the medial wall of the piriform sinus). All 4 marginal samples were found to be tumor-free by the pathology colleagues. An R0 resection can therefore be assumed. Repeated inspection. Dry conditions. The patient was then repositioned on the right side for the neck dissection. Skin spray disinfection, application of local anesthesia, skin ablation and sterile draping. First make a skin incision. Cut through the subcutaneous tissue and the platysma. Exposure and ligation of the external jugular vein. Creation of a subplatysmal flap in a cranial and caudal direction. Exposure and sparing of the cranial auricular nerve. Exposure of the accessorius nerve, the posterior venter of the digastric muscle and the omohyoid muscle. Dissection along the internal jugular vein from caudal to cranial. Dissection along the entire cervical vascular sheath. At least 3 masses were then visualized along the internal jugular vein, which appeared highly suspicious. Successive removal of the posterior neck specimen while sparing the above-mentioned structures and the plexus branches. Removal of the anterior neck preparation and thus evacuation of regions I b, II, III, IV and V. Hemostasis there by means of bipolar coagulation. Irrigation of the wound using hydrogen peroxide and Ringer's solution. Dry conditions. Application of a 10 Redon drainage, two-layer wound closure. Subsequent creation of an approx. 4 cm long incision along the lower edge of the cricoid cartilage. Separation of the subcutaneous tissue and platysma. Exposure and transection of the prelaryngeal musculature in the midline. Exposure of the thyroid isthmus, which is undermined and severed after treatment using bipolar coagulation. Exposure of the anterior wall of the trachea. Creation of a transverse incision between the 2nd and 3rd tracheal cartilage clasp. Formation of a Björk flap. Epithelialization of the tracheostoma. Skin suture and transfer of the patient to a size 8 Rügheimer cannula. Repositioning of the patient to perform a neck dissection on the left side. Skin incision. Dissection of the subcutaneous tissue and the platysma. Exposure of the auricular nerve. Exposure and ligation of the external jugular vein. Exposure of the accessorius nerve, the posterior venter of the digastric muscle and the omohyoid muscle. Exposure of the internal jugular vein, the vagus nerve and the common carotid artery. Dissection along the cervical vascular sheath from caudal to cranial. Successive removal of the posterior neck preparation. Subsequent removal of the anterior neck specimen. There were 2 conspicuous lymph nodes at the level of the upper venous angle. Dry conditions after hemostasis using bipolar coagulation. Wound irrigation with hydrogen peroxide and Ringer's solution. Placement of a 10 Redon drain, two-layer wound closure. Subsequent re-inspection of the hypopharynx on the right using a Kleinsasser C-tube. Dry conditions there. Removal of the small water tube and completion of the procedure without complications.