The keywords of surgical treatment in the 21st century are "minimally invasive" and "function preserved". "Laryngeal function" is important in the head and neck region. The goal of laryngeal function preservation surgery is to be able to talk on "telephone" (vocalization function), to be able to "eat out" (chewing/swallowing function), "bath to shoulder" (nasal respiration function). Minimally invasive surgery and function-preserving surgery for head and neck cancer have been developed mainly for transoral surgery. In Japan, oral endoscopic surgery is the main surgical method. Transoral videolaryngoscopic surgery(TOVS)and endoscopic laryngo-pharyngeal surgery(ELPS)developed in Japan are widely performed. On the other hand, transoral robotic surgery(TORS)is commonly performed overseas, and insurance adaptation is expected in Japan in the future. Open surgery is available for invasive cancer cases that transoral surgery is inappropriate. Because it is deeper and wider resection, it is necessary to understand the method of setting appropriate resection area and swallowing improvement surgery. Then you can increase options for function-preserving surgery by open surgery for patients. Advances in imaging equipment present a very fine organizational structure on a large screen. The expanded surgical field will allow for highprecision surgery and minimize postoperative functional damage. We are not bound by existing concepts but we must seek next generation surgery that incorporates evolved technology.