Pay it forward: Strategies for successful implementation of short-term endocrine surgical mission

Introduction: With increasing interest in humanitarian surgical efforts, numerous opportunities for specialized mission trips have developed. Extreme short-term surgical “blitzes” of specialist teams have offered much-needed surgical care but lack efforts for patient continuity and local sustainability. We sought to define characteristics that aid in the long-term success of short-term international surgical missions to better apply this insight toward future dedicated humanitarian endocrine surgical efforts. Materials and methods: A broad search engine review identified 1,954 reports of medical and surgical missions. One hundred and sixty-six of these abstracts involved surgical missions from 2009 to 2014 with 24 articles including details of specific mission trips. We identified factors deemed essential for improving patient care and affecting local infrastructure for longterm sustainability and included our prospective experience with an endocrine surgery-specific mission trip for comparison. Results: Of the 24 articles reviewed, missions went to Africa (9), North America (8), South America (5), and Asia (5). Factors for mission sustainability and success included the following: (a) ability to educate local physicians and trainees, (b) multiple return trips to the same location, and (c) formal pre-mission planning and site visits. Emerging interest is on optimizing patient outcomes and cost-effectiveness. Conclusion: Short-term surgical missions require a local infrastructure for optimal patient outcomes. Sustainability hinges on education and involvement of local physicians and surgical trainees, pre-mission planning, and return trips to the same location. For endocrine surgical missions, preoperative evaluation and postoperative follow-up by the operating surgeon is important for optimizing performance and outcomes.