Endoscopic surgeries have gained popularity not only in Otolaryngology but also in other surgical fields. Endoscopes and the Hopkins rod lens system have revolutionized the medical field in last half century. Endoscopic approach for paranasal sinuses is well known. The well-established techniques in tympanoplasty are routinely performed with operating microscopes for many decades. Endoscopic ear surgeries provide minimally invasive approach to the middle ear and is an evolving science in the field of otology. Migrating from classical Wullstein’s microscopic tympanoplasty techniques to endoscopic tympanoplasty techniques is slow and tough but still a new horizon is rising in the field of otology. [1,2,3]
Need for the invention:
In spite of the advantages of endoscopic ear surgeries including panoramic vision and the ability to visualise beyond the corners, the disadvantage is that it is one-handed surgical technique as the non-dominant left hand of the surgeon is utilized for holding and manipulating the endoscope. This necessitated the need for development of the endoscope holder which would allow both hands of surgeon to be free for surgical manipulation [1-4].
Technical Description (figure 1,2, 3):
Innovative Idea for patent is “Applying all actions and motions of surgical microscope to drive the rigid endoscope in any biological cavity in all 360 degree. It is a metallic plate  of 90 x 40 x 12 mm in dimensions with a slot measuring 15 x 15mm in diameter. This plate is fixed to rack and pinion system (which is available for fine focusing) of any operating ENT microscopic stand with 2 screws after removal of the optical observation instrument of the microscope. Half of the circular slot (15 mm diameter) is on the main attachment and the other half is on opening metallic plate. When approximated with each other both the halves of the slot accommodate the endoscope after fixation. This opening part of metallic plate is attached to main part with hinge joint with 90 degree of motion. In other variant instead of hinge joint, the opening part can be fixed with two identical long adjustable screws. The inner part of circular slot is reinforced with soft silicone to hold neck of endoscope firmly without any undue pressure on optical fibres of the rigid endoscope. This slot is at 80mm distance from its attached end and can be made of any suitable diameter to accommodate different rigid endoscopes of different diameters.
Advantages of Endohold™:
1. Our endoscope holder is innovatively modified from operating microscope used for two handed endoscopic Ear, Nose & Throat surgeries [4-9] and thus retains all advantages of operating microscope (figure 4).
2. During Ear surgery with endoscope, it is very critical to work in ear canal of 24 mm length precisely. Our endoscope holder is mounted on rack and pinion system of Fine focusing of operating microscope, thus making the movement of the endoscope precise, smooth and accurate after it is placed in the external ear. There is no jerky movement of endoscope due to its fixity into the holder. As the floor model is sturdy, it bears the all different weights of additional camera and fiber-optic cables easily.
3. It gives a stable image on the monitor.
4. Minimal need for assistance.
5. No surgeon fatigue holding the endoscope.
6. Combines advantages of endoscope for endoscopic ENT surgeries.
7. Better Optics for better visualisation and precision with accurate surgical correction.