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Copyright 2020 Biolife Sas. www.biolifesas.org.In recent years, minimally invasive surgeries have been undergoing a revolution with the development of robotic assisted surgery. Due to the anatomical region in which many operations are carried out, in small spaces through natural orifices in the body such as the mouth, the nose or the ear, as well as the esthetic discomfort caused by external scars in the head and neck, the use of robotic assisted surgery in the field of head and neck surgery is gaining momentum and is being implemented more and more in Israel and around the globe. Most of the operations currently performed in otolaryngology are carried out through the oral cavity or through distant and camouflaged skin cuts. In this article we will review the new applications and technologies in the field of surgical robotics in otolaryngology - head and neck surgeries, as well as summarize the experience of the Department of Otorhinolaryngology and Head and Neck Surgery at the Rabin Medical Center in robot assisted surgeries.Head and neck cancer is the sixth most common malignancy worldwide. Along with other "classical" risk factors such as tobacco and alcohol use, the human papillomavirus (HPV) is well established to play a pivotal role in the development of head and neck cancers, particularly in oropharyngeal cancer (OPC). While head and neck cancer incidence decline worldwide, OPC is on the rise. The incidence of HPV-positive oropharyngeal carcinoma predominantly increased in younger, married male patients with higher socioeconomic status and with high-risk sexual practices. This OPC subtype is characterized by limited local tumor with a substantially larger regional nodal disease. However, HPV-positive OPC patients exhibited a significantly better prognosis than patients with HPV-negative OPC, leading to a recent change in the clinical guidelines. The current non-surgical standard of care for OPC results in excellent disease control, though associated with substantial toxicity. Numerous studies now focus on less intensive (i.e., deintensified) treatment for the improvement of patient safety while maintaining excellent disease control. Furthermore, the recent development of more advanced surgical techniques with promising outcomes may shift the therapeutic paradigm back to the operating room. During the past decade, there is widespread use of HPV vaccination, and lately, it was also approved for boys. However, the preventive effects of the HPV vaccine on head and neck cancers, particularly on OPC is yet to be determined.The American Joint Committee on Cancer (AJCC) staging manual has become the point of reference for classifying patients with cancer, defining prognosis, and determining the best treatment approaches. The eighth edition of the Head and Neck AJCC Cancer Staging Manual incorporates significant changes based on advances in our understanding of the etiology and certain histologic attributes of tumors. Changes were made only when there was strong evidence for inclusion, while balancing between "population-based" and a more "personalized" approach. We describe the main changes implanted into the AJCC 8th edition while analyzing the effects on treatment plans and survival metrics. 1. The most significant update, to better reflect the variety of diseases arising in the pharynx, creates a separate staging algorithm for high-risk human papillomavirus-associated cancer of the oropharynx. Therefore, pharynx carcinoma has been divided into 3 separate chapters - nasopharynx, high-risk HPV-associated (p16-positive) oropharynx, and hypopharynx and non-high risk HPV-associated (p16-negative) oropharynx. 2. Another important update incorporates extra nodal extension as a prognostic variable for regional lymph node metastases in non-viral associated head and neck tumors. check details 3. Significant changes to the tumor (T) categories for oral cavity are discussed, where, for every 5-mm increase in depth of invasion (DOI), categories will increase one level, demonstrating better consistent and predictive survival curves. 4. A major tumor (T) category change for nasopharyngeal squamous cell carcinoma (SCC), regarding the prevertebral and pterygoid muscles, is discussed. We go through the rationale behind the major changes while practicing the new staging system among different cases.Surgeon performed ultrasound (SUS) has become a valuable tool for the head and neck/endocrine surgeon. It allows for a complementary examination of the neck, following history and physical examination. With its reduced costs and being radiation free, US has become the modality of choice for imaging thyroid, parathyroid and lymph nodes of the neck. In thyroid cancer, the role of US has constantly grown, as reflected in the latest American Thyroid Association (ATA) guidelines The shift from whole body iodine scans to US has allowed for surveillance in low risk patients who underwent thyroidectomy, follow-up of microcarcinomas, and has a key role in the assessment of a thyroid nodule following initial aspiration. However, US is still limited by operator dependent inherent flaws, which are reflected by a relatively moderate inter-observer agreement, even among experts. When conducted by the same surgeon, SUS allows the patients to enjoy the benefits of US while overcoming this limitation. When compared to radiologist-performed US, several studies have shown that high volume surgeons can reach non-inferior predicative values for malignant nodules, using accepted suspicious sonographic features such as solid texture, hypoechogenicity, microcalcifications, irregular margins and taller rather than wider shape. Several studies have tried to answer the most important utility of SUS - its ability to change the course of management of the cases. In all studies SUS was able to change the management of the cases in 17-45% of the patients, extending surgery in some patients while avoiding unnecessary dissections in others. In summary, SUS is an important, feasible tool for the head and neck and endocrine surgeons. Studies have shown that high volume surgeons can reach excellent rates of prediction and detection, thus saving the patients unnecessary clinic visits, tension and additional imaging, and can even directly influence the management of the patients.