The development of an international partnership for cranial neurosurgery in The Gambia.

BACKGROUND

There is a considerable burden of pituitary and other skull base diseases in low-and-middle-income countries that often go unaddressed. In this study, we describe the development of an institutional partnership between Mass General Brigham (MGB) and the Edward Francis Small Teaching Hospital (EFSTH; The Gambia) to develop the capacity to perform complex cranial neurosurgery with a focus on pituitary surgery.

METHODS

This is a case series of 5 operations performed at EFSTH from September 17-19, 2024.

RESULTS

5 operations were performed, including 3 for pituitary macroadenoma, 1 for giant falcine meningioma, and 1 for postcentral gyrus tuberculoma. Operative times ranged from 3 to 9 h and estimated blood loss ranged from 200 to 800 cc. There were no intraoperative complications, though one patient suffered a delayed venous infarction that caused transient weakness and inability to ambulate. All patients were discharged home, and all patients' preoperative symptoms improved by final follow-up. The crude long-term cost efficacy of performing pituitary surgery was approximated to be $21 US dollars (USD) in productivity gained for every $1 spent.

CONCLUSIONS

We describe the early development of a new global neurosurgery partnership between EFSTH and MGB, which includes the country's first pituitary operation.