Perceived benefits of endoscope holder use in neuroendoscopic procedures: A multi-institutional survey study

Background: Manual endoscope control during neuroendoscopic surgery may compromise visualization, ergonomics, and surgical workflow. Mechanical endoscope holders have been introduced to address these limitations, but their practical impact remains underexplored in neurosurgical field. Materials and Methods: A cross-sectional survey was conducted at nine neurosurgical centers between April and June 2025. Twenty-seven participants (9 each of surgeons, assistants, and scrub nurses) with experience using a floor-mounted pneumatic endoscope holder (UniARM) completed a structured, role-specific questionnaire comprising usage patterns and 5-point Likert scale assessments of perceived benefits. Results: Most surgeons had 5–10 years of experience and performed 20–40 endoscopic procedures annually. Endonasal and transorbital approaches were the most common indications for both endoscope and holder use. Holder use was preferred over manual holding in most procedures, except intraventricular cases. Surgeons reported high satisfaction, particularly for stable visualization (4.78 ± 0.44) and enhanced surgical focus (4.67 ± 0.50). Assistants gave consistently high scores across domains, particularly for reduced physical fatigue and improved task concentration (both 4.89 ± 0.33). Scrub nurses highlighted improvements in procedural flow and team communication (4.44 ± 0.53), while ergonomic benefits were less pronounced (2.78 ± 0.44). Conclusions: Mechanical endoscope holders were positively evaluated by all surgical team members, offering clear benefits in visual stability and workflow efficiency. While device limitations remain, their broader use may improve efficiency and team coordination in neuroendoscopic surgery.