After active patient identification, the patient is brought into the operating theater. Carry out the team time-out. Introductory consultation with anesthesia colleagues. Induction of anesthesia and intubation of the patient. Positioning of the patient by the surgeon. Skin spray disinfection and infiltration anesthesia. Skin wipe disinfection and sterile draping. First mark the planned incision after palpatory identification of the thyroid incisura and the upper edge of the cricoid cartilage. Make the incision using the broken-line technique. Sharp cutting of the cutis as well as the subcutis. Expose the prelaryngeal musculature. Locate the median line. Lateralization of the prelaryngeal musculature and exposure of the thyroid cartilage. Insertion of the sharp retractors. Incise the periosteum from the thyroid incisura to the lower edge of the thyroid cartilage. Dissection of 2 perichondrium lobules and lateralization of the same. Horizontal incision of the ligamentum conicum. Incision with the wheel and opening of the laryngeal skeleton in the median line. A tumor can now be seen extending from the right vocal process via the anterior commissure to the middle third of the left vocal fold. Initially beginning on the right side. First infiltration anesthesia glottic right. Then resection of the right vocal fold, including the vocal ligament, the vocalis muscle and parts of the thyroarytenoid muscle. In some cases, it is necessary to resect down to the perichondrium of the inner surface of the thyroid cartilage. The same procedure is also carried out on the left side. Here the resection only extends to the posterior third, taking the middle third with it. Here too, the extent of the resection is carried out via the vocal ligament and the vocalis muscle to the arytaenoid muscle. In the ventral part of the resection area, resection is also performed down to the inner perichondrium leaf of the thyroid cartilage. This is followed by hemostasis using bipolar coagulation. Removal of circular margin samples. Right: upper front, upper back, lower back, lower front; left: upper front, upper back, lower back, lower front. During the telephone frozen section examination, extensions of a squamous cell carcinoma in situ can still be seen subglottically on the right. Therefore, a definitive resection and a new marginal sample are taken and also sent for frozen section diagnostics. This is found to be tumor-free intraoperatively. Therefore, proceed to closure of the larynx. Creation of a total of 4 drill holes. Insertion of a 14 mm laryngeal wedge. Suturing with Vicryl 4.0. Creation of 2 additional drill holes to achieve adequate closure of the laryngeal skeleton. Closure of the incision in the area of the ligamentum conicum. Mobilization of the two perichondrium flaps. These are folded over the Keel and sutured in the median line. Overall very good aspect. Insertion of a sterile flap. Re-adaptation of the prelaryngeal musculature. This is also sutured with Vicryl 4.0 in the median line. Prior to this, wound irrigation with H2O2 and Ringer's solution. Subcutaneous suturing with Vicryl 4.0 and skin suturing with Ethilon 5.0. Application of a wound dressing and a wrap and completion of the operation without complications after a final consultation with the anesthesia colleagues.