After induction of anesthesia and intubation by the anesthesiologist, entry with the Kleinsasser tube. Inspection of the hypopharynx and larynx. The tumor described above can be seen in the area of the left pocket fold, moving forward into the anterior commissure and also infiltrating the vocal fold on the left. The piriform sinus, epiglottis and vallecula are tumor-free. A PEG tube is then inserted in the usual way. This can be done without any problems via the old PEG insertion site. Then mark the skin incision and make the incision median to the neck. The laryngeal skeleton can now be prepared directly. The larynx is skeletonized. Exposure of the hyoid bone. Skeletonization of the hyoid bone and removal of the hyoid bone. Then release of the thyroid gland on both sides. Separation of the oblique laryngeal muscles. Dissection of the cervical vascular sheath from the larynx. Exposure of the trachea. Release of the upper thyroid cartilage horn, initially on the right side. Then incision of the periosteum on the thyroid cartilage and removal of the piriform sinus. The same is done on the opposite side. Unfortunately, it cannot be done this far, as the tumor is located on this side. Then expose the pharynx, directly below the base of the tongue at the level of the epiglottis. Pull out the epiglottis and cut around the epiglottis, first on the right side, then on the left side. Release the larynx also in the postcricoid region. Then perform the tracheotomy below the cricoid cartilage and reintubation. Deposition of the laryngeal preparation below the cricoid cartilage. It can be seen that the tumor is relatively close to the resection margin on the lateral pharyngeal wall in the transition to the piriform sinus. To be on the safe side, a large resection is taken and a frozen section is also made of the site, which is ultimately classified by the pathologist as carcinoma in situ and tumor-free. The specimen is sent to the pathologist marked with a thread. Now start with the pharyngeal suture. First at the base of the tongue, then from caudal to cranial, so that the sutures virtually meet in the middle of the pharyngeal defect. Single button sutures are made. Then second single button suture in the usual manner and third pharyngeal suture by beating the thyroid gland and the remaining muscles over it. Insertion of two Redon drains and formation of a tracheostoma through a mucocutaneous anastomosis. Before the pharyngeal suture, a Provox prosthesis was of course inserted in the usual manner, size 8, with the trocar approx. 1 cm below the stoma. Two-layer wound closure. The operation was completed without complications. Please continue antibiotic treatment and X-ray swallow on the 10th postoperative day. If a fistula is suspected, please open the neck.