Lately, the transoral approach is being widely used for surgical treatment of head and neck cancer and is particularly preferred for robotic surgery. However, this strategy cannot be used in all patients, and some tumors need to be resected through a conventional transcervical approach. Currently, robotic surgery for head and neck cancer is approved by the Japanese government but is not covered by the public medical insurance system. Therefore, Japanese surgeons have developed innovative surgical approaches, such as endoscopic laryngopharyngeal surgery (ELPS) and transoral video-assisted surgery (TOVS), which offer advantages such as low cost, finer and sharper tips of forceps, and better haptic feedback than that observed with robotic surgery. In this session, we discuss advances in surgical treatment for head and neck cancer in Japan. This session will begin with Dr. Sano’s presentation regarding treatment outcomes of transoral surgeries for oropharyngeal, hypopharyngeal, and supraglottic squamous cell carcinoma in Japan, with a comparison between transoral robotic surgery and non-robotic surgeries, such as ELPS or TOVS. Following this topic, Dr. Matsumoto will describe function-preserving surgery using an external approach. It should be emphasized that robotic surgery will not completely replace open surgery. Moreover, Dr. Asakage will describe his personal experience with the management of 100 cases of skull base surgery and discuss new techniques such as an endoscopic combined approach.