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Expert Lectures (CME ENThusiast)

Endocrine Surgery

Safety of Goiter Surgery in Sub-Saharan Africa: Lessons Learned Over 20 Years

Saturday, September 28, 2024
1:00 PM – 1:50 PM EDT
Location: MBCC, Lincoln Road EF
CME/MOC Credit: 1
Disclosure(s):
Merry E. Sebelik, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

jagdish K. dhingra, MBBS, FRCS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

PROGRAM DESCRIPTION: 5% of the world population suffers from goiter, and 75% of people with goiter live in the Global South. In many of these healthcare settings, thyroid surgery technology and human resources may be limited. Increasing access to safe thyroid surgery can be achieved by increasing the number of local skilled surgeons, a transition that can be aided by collaboration with surgeons who practice in higher resource environments.

The expert presenters share between them more than 40 combined years of experience performing and teaching thyroid surgery in austere settings in Sub-Saharan Africa. This wealth of knowledge and experience has resulted in the development of best practices to optimize patient outcomes, and can result in more thoughtful utilization of resources in the higher income setting as well.

This Expert Panel will commence with a review of the known evidence basis for "ideal" performance of thyroid surgery, including some controversial aspects such as patient selection, extent of surgery, techniques for recurrent nerve monitoring and achievement of hemostasis.

The audience will be challenged to reflect and respond to queries about their own practices, and attitudes toward what they could do without if in a more resource constrained environment than they are accustomed to. This dichotomy has been explored in a prior Academy presentation (2011) and real-time result analysis will provide a fascinating view of potential attitudinal changes over the ensuing time span.

After opening up the floor to discussion of the audience response results, the program will conclude with the introduction of a 10-point Thyroid Surgery Checklist the expert presenters have developed and adhere to in their delivery of safe thyroid surgery in healthcare settings across the resource spectrum. Case presentations will be available to illustrate the application of the checklist, and challenging cases from the audience will be elicited as time allows.

Learning Objectives:

  1. Review “best practices” for goiter surgery through review of evidence-based publications and examine how equivalent outcomes can be achieved in the absence of the most expensive technologies.
  2. Compare and contrast practice patterns in high resource environments versus those practices allowed within lower resource settings. Audience responses will be elicited to better illustrate this learning objective and to consider more thoughtful use of resources no matter the setting.
  3. Introduce a 10 point goiter surgery-specific checklist in preoperative, intraoperative and postoperative goiter surgical management, found to achieve the highest level of care within a variety of settings.

    Co-Presenter(s)

  • Merry E. Sebelik, MD

    Professor, Division of Endocrine Head & Neck Surgery
    Emory University
    Atlanta, GA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Lead Presenter(s)

  • jagdish K. dhingra, MBBS, FRCS

    Associate Professor
    Tufts Unversity School of Medicine
    Brockton, MA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.