With the development and popularization of endoscopic thyroidectomy, this surgical approach is increasingly accepted by more medical centers and patients. However, due to its relatively narrow operating space compared to laparoscopy and thoracoscopy, as well as issues such as the shared space between the lens and the surgical instruments manipulated by the primary surgeon, mutual interference, and limited visibility, it often becomes a challenging aspect of the surgery. To address this issue, the authors, from the perspective of the camera-holding assistant, introduce the concept of scene-based guidance. This is achieved by standardizing the key points of operation and quality control for camera-holding assistant during gasless axillary endoscopic thyroidectomy in three parts. The first part standardizes preoperative preparation and the division of the operating area of the camera-holding assistant. The second part outlines the key points of endoscope operation: "YAN GUAN LIU LU, SAN GE PING MIAN, JIN TUI ZHAN ZHUAN" a twelve-character quality control mantra for the camera holding. The third part focuses on the quality control of the endoscopic view field in three progressively deeper levels: dividing the surgical area into the recurrent laryngeal nerve area, the upper pole of the thyroid area, and the pre-tracheal area, thereby standardizing the key points and visual guidance for the camera-holding assistant in different scenarios. Through camera-holding skills and quality control, the surgical field is more fully and clearly visible, visual guidance is smoother, mutual interference between the lens and instruments is reduced, the average number of lens wipes or soaks during surgery is significantly reduced, and even secondary wiping of the lens during surgery is unnecessary, ensuring continuous operation and saving surgical time. Here, the authors elaborate on the above points, operation techniques, and details