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Objective: There exist a lack of endocrine surgical expertise globally, especially related to endemic thyroid disease, which is often under-diagnosed and inadequately managed. The design and feasibility of an outreach camp to provide surgery to an underserved population and intensive endocrine surgery exposure for trainees were evaluated.
Design: Prospective evaluation of a collaborative 1-week surgical outreach camp.
Setting: Nebbi General Hospital, Uganda.
Patients: Radio announcements and screening to identify patients with symptomatic thyroid disease were performed by local providers prior to the camp.
Interventions: Detailed preoperative evaluation by surgery and anesthesiology identified 36 patients likely to benefit from surgical intervention, and were operated on by 3 attending surgeons (2 Ugandan), and 6 surgical residents (5 Ugandan). Lectures related to endocrine surgery were presented daily to the team.
Main Outcome Measures: Successful completion of the surgical camp.
Results: The average age of the patients were 41.0 years (range 7-79 years), with 92 % being female. Of 36 operations performed, there were 9 subtotal thyroidectomies, 22 thyroid lobectomies, 1 isthmusectomy and 4 resections of thyroglossal duct cysts. Despite modification to technique (e.g. lack of electrocautery and suction), the surgical quality was maintained. There were no major complications, whereas three patients required drainage for seroma.
Conclusions: The camp provided needed high-quality operations to an underserved population in northwestern Uganda. The collaborative nature and the focus on instruction to local surgical trainees represents a model which may have broad and long-term impact in a resource-limited community.