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 1 US dollars (USD) in productivity gained for every 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.