After induction of anesthesia and intubation by the anesthetist, the first step is microlaryngoscopy: this reveals a partially exophytic mass in the laryngeal epiglottis, which clearly reaches the midline on the right. The aryepiglottic fold is just affected, but the right arytenoid cartilage is free. The right pouch fold and vocal fold are free. On the left side, the tumor extends minimally over the laryngeal epiglottis midline, otherwise the vocal folds, the pouch folds and the aryepiglottic fold are free of irritation. The tumor grows submucosally into the pre-epiglottic field and bulges the right vallecula without breaking through it. Now proceed with the flexible esophagogastroscope under constant air insufflation with positive diaphanoscopy. Insertion of the troicart and placement of the PEG tube in the typical manner using the thread pull-through method. Now proceed to tumor resection and neck dissection on both sides: First, a U-shaped incision is made to form the apron flap, starting at the level of the cricoid cartilage. Dissection through the subcutaneous tissue and platysma. Subplatysmal dissection of the apron flap is then performed up to the level of the hyoid bone. Now turn first to the right side of the neck: Dissect along the anterior border of the sternocleidomastoid and then expose the digastric muscle and the omohyoid muscle. Identify and protect the accessorius nerve. Now clamp the surgical site with the retractors and dissect the internal jugular vein from caudal to cranial. Simultaneous dissection of the facial vein. The medial neck preparation is then formed after identification and protection of the hypoglossal nerve, the superior thyroid artery and the submandibular gland. In addition, the superior layngeal nerve and its accompanying vessels are identified here. Now turn to the lateral neck preparation. First isolate the internal jugular vein, identify and protect the vagus nerve and then dissect from cranial to caudal, protecting the accessor nerve and the plexus branches. Now turn to the neck dissection of the left side: identical procedure here. Dissect the sternocleidomastoid muscle along its anterior edge. Identify and spare the accessorius nerve. Set the border at the posterior digastric venter muscle and omohyoid muscle. Spanning of the surgical area and dissection of the internal jugular vein from caudal to cranial. After skeletonizing the submandibular gland, the median neck preparation is dissected after identifying and sparing the hypoglossal nerve, cervical nerve and superior laryngeal nerve as well as the superior thyroid artery. Then, after isolating the jugular vein, the vagus nerve is identified and spared and the lateral neck preparation is formed from cranial to caudal, sparing the plexus branches. Far in the caudal region, there is initially a watery flow, which may be due to injury to a small hilar vessel. For this reason, the area is carefully bipolized and a TachoSil swab is placed at the end. The surgical site is then completely dry. Level VI is now also prepared. This is done directly caudal to the hyoid bone and on the surface of the thyroid and omohyoid muscles and caudally to the cricoid cartilage. The anterior jugular vein is ligated on both sides. Now spread the prelaryngeal and pretracheal muscles. Identify the thyroid isthmus. Identification of the inferior thyroid vein and bipolization of the latter. Undermining of the thyroid isthmus, clamping with 2 Péan clamps and transection of the same. This is followed by suturing with Serafit 0 sutures. Now explore the anterior tracheal wall between the 2nd and 3rd tracheal ring. Form a Björk flap and epithelialize it in the caudal area. Now skeletonize the hyoid bone. Separate the omohyoid and thyroid muscles at the cranial insertions and open them caudally. Now carefully isolate the superior laryngeal nerve on both sides and separate it from the nearby upper horn of the thyroid cartilage. The tumor can now be palpated in the thyrohyoid membrane on the right side. However, it can be seen that it does not infiltrate the thyroid cartilage. Now add <CLINICIAN_NAME>, which opens the thyrohyoid membrane on the left side and enters the vallecula region. The epiglottis is then opened outwards with the tumor grasping forceps and the exact extent of the tumor is identified. Resection is then performed along the vallecula on the right side, then via resection of the pharyngo-epiglottic fold and further resection along the aryepiglottic fold on the right side. Shortly before the arytenoid cartilage is reached, the resection is then continued from posterior to anterior, partially taking along the fold of the pocket. On the left side, on the other hand, most of the pocket fold and the aryepiglottic fold can be spared and the resection goes directly from the laryngeal epiglottis into the pharyngo-epiglottic fold. The specimen is sent for final histology. The resection appears to be clearly in sano. Nevertheless, 3 frozen sections are taken, which are then found to be tumor-free. Now careful hemostasis. The mucosa of the right pocket fold is readapted to the thyroid cartilage as far as possible, the upper horn of the thyroid cartilage is resected on both sides while sparing the superior laryngeal nerves. On the left side, the mucosa of the epiglottis attachment is adapted to the thyroid cartilage. The mucosa of the pharyngeal wall is then laterally readapted to that of the base of the tongue on both sides using three 3/0 Vicryl sutures each. The thyroid cartilage is now reattached to the hyoid bone. This is secured with three lateral 0-Vicryl sutures and an additional central 0-Vicryl suture placed directly caudal to the incisura thyroidea. All sutures are advanced and pass around the hyoid bone. Then all are successively adapted and attached after the head has been reclined. In addition, an attempt is made to readapt the mucosa as well as possible with 3/0 Vicryl sutures. The thyrohyoid and omohyoid muscles are then reattached and both muscles are sutured to the hyoid bone so that the resection site is covered. Then careful hemostasis and irrigation with hydrogen and Ringer's. Placement of 2 Redon drains. Auklapping of the apron flap and epithelialization of the tracheostoma and two-layer wound closure using subcutaneous and skin sutures. Intraoperative administration of 3 g Unacid. The patient should not be fed orally for at least one week. This should be followed by an X-ray papsule. After receiving the final histology, presentation at the tumor conference.