Adjustment of the tumor with the small water tube. The laser is now used to clinically cut around the tumor in a healthy state. The free part of the epiglottis practically falls away completely. The resection extends to the base of the tongue on the left and the aryepiglottic fold on the left. The tumor is removed in toto. Overall difficult conditions due to the setting. Repeated bleeding, which makes dissection difficult. Removal of circular margin samples. These are found to be tumor-free in the frozen section. An R0 resection can be assumed. Now insertion of the PEG. To do this, insert the flexible endoscope into the esophagus. Advance into the stomach. Good diaphanoscopy. Some hyperplastic mucosa in the stomach, otherwise unremarkable conditions. Placement of the PEG with the thread pull-through method in the usual manner. No bleeding, no other special features. Now reposition the patient and perform neck dissection on both sides. Start with the left side. Infiltration anesthesia 3 times at the anterior border of the sternocleidomastoid muscle. Then skin incision. Dissection of the subcutaneous tissue. Exposure of the sternocleidomastoid muscle, the internal jugular vein, the accessorius nerve, the external, common and internal carotid artery and finally the internal jugular vein and facial vein. Dissection of the digastric muscle and clearing of the accessorius triangle. Exposure of the vagus nerve and removal of the posterior neck preparation - overall subtle preparation of a relatively large amount of subcutaneous tissue. Some bleeding makes dissection difficult. These are stopped with bipolar coagulation. Now dissection of the anterior part of the neck. Exposure of the hypoglossal nerve, the submandibular gland, removal of the capsule of the submandibular gland and removal of the anterior neck preparation while sparing the previously mentioned structures. Extensive hemostasis with H2O2. Bipolar coagulation. Irrigation with NaCl. No more bleeding. Insertion of a Redon drainage. Subcutaneous suture, skin suture, wound dressing. Now repositioning of the patient and neck dissection on the right. Here too, three infiltration anesthesia at the anterior edge of the sternocleidomastoid muscle. Now skin incision. Dissection of the muscle. Exposure of the internal jugular vein, the accessorius nerve, the common, external and internal carotid arteries and the vagus nerve. Dissection of the posterior digastric venter muscle. Very difficult dissection in the accessorius triangle. Finally, removal of the posterior neck preparation up to supraomohyoidal. Protection of the structures mentioned. Dissection anteriorly, dissection of the facial vein, exposure of the submandibular gland, removal of the capsule. Exposure of the hypoglossal nerve and the cervical nerve. Evacuation of the anterior neck preparation to the caudal side. Hemostasis with H2O2. Bipolar coagulation. No more bleeding. Insertion of a Redon drainage. Subcutaneous suture, skin suture, wound dressing. At the end of the procedure, control endoscopy and visualization of the resection area in the larynx. A small oozing hemorrhage is stopped with monopolar coagulation. No more bleeding now. No tracheotomy due to the still standing restepiglottis. Control in the intensive care unit. Intraoperative administration of Unacid and cortisone.