Abstract:With the development and promotion of endoscopic thyroid surgery, transaxillary endoscopic thyroid surgery has been proven to be a safe and feasible surgical method. Among them, gasless transaxillary posterior endoscopic thyroid surgery (GTPET) has been widely accepted and adopted due to its clear field of vision without gas interference. However, due to the characteristics of the lateral viewing angle, shared surgical space of the lens and instruments, inherent difficulties exist in the surgical operation. To solve the problem of visual angle coordination in endoscopic operations, some teams have applied an assistant robot. However, for GTPET, which has a small operating range, the surgical view and operation still depend on the coordination of the surgeon and the camera-holding assistant. To overcome the difficulties in GTPET procedures, the author introduces the concept of "scene-based" operations, focusing on the perspective of the camera-holding assistant. This involves standardizing the assistant's operational procedures during the GTPET surgery into three parts. Firstly, preoperative preparation: standardizing patient positioning and the location of the camera-holding assistant. Secondly, key points for the assistant's operation: summarized as "one pivot," "two approaches," and "three planes." Thirdly, the "four-quadrant" method was used to assist the operation by visualizing the field of endoscopic view, dividing the surgical area into zones I to Ⅳ and guiding the surgical procedures accordingly.