Dear Colleagues,

Minimally invasive surgery has been adopted in many areas of surgery to reduce patient morbidity during surgical resection. To achieve this, endoscopic and robotic instrumentation coupled with improved imaging tools and localisation techniques have been developed, to enable adequate resection of tumours with minimum damage to surrounding tissues. Minimally invasive surgery is a fast growing research field and in in the last two decades there has been much new research and many applications have been acquired in different fields of head and neck surgery.

For example, 4K and 3D endoscopes now allow for a better definition of surgical narrow fields. Extracorporeal video microscopes, or "exoscopes", provide a high-definition view of the operative field and are alternatives to the operating microscope or loupes for large-corridor surgical approaches. Surgical robots arose from the need to reproduce the same movements and type of dissection performed in open surgery, maintaining the advantages of minimally invasive surgery. This is made possible by instruments capable of performing 360° movements thanks to the degrees of freedom of the robotic arms and articulated tools. Moreover, by means of robotics it is possible to limit the tremor of the hands and amplify the vision ten times in three dimensions, therefore performing movements of extreme precision.

In head and neck surgery, numerous studies have shown an equivalence of minimally invasive surgery compared to open surgery in terms of oncological radicality, however, other studies have confirmed that the minimally invasive approach is superior in terms of post-operative quality of life and the earlier resumption of normal life. While in the initial stages of head and neck cancer, minimally invasive surgery—manual and robotic—is today the standard of treatment. The future interests of minimally invasive surgeons in the coming years will be addressed to more complex procedures including the treatment of locally advanced cancers after chemotherapy. In this Special Issue we will review the techniques, indications and results of the application of minimally invasive surgery in the head and neck, focusing not only on the current standard, but also evaluating future applications and new perspectives.

Dr. Armando De Virgilio
Prof. Dr. Giuseppe Spriano
Guest Editors

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• Head and Neck Surgery
• Minimally Invasive Surgery
• Head and Neck Oncology
• Reconstructive Surgery
• Robotic Surgery