Elephant Surgery

Surgical treatment of a cervico-vaginalprolapse in anelephant inMyanmar

Zaw Min Oo1, Myo Nay Zar1, Aung Thura Soe1, HtooHtooAung1, Kyaw Soe1, Kyaw Nyein1, Win Htut1, Myo Shwe1, Aung Myint Tun1, Than Soe1, Than Naing Oo1, Than Zaw Win1, Moe Win Tun1, Ko Moe1, Thi Han Chit1

Myo Than2, Wan Tun2, Ba Kyaw Than2

Moe Myint3, Thiha3, Moe Zaw Aung3, Than Min Swe3

1 Elephant veterinarian, MTE Department of Timber Extraction, MOECAF

  1. 2  Retired elephant veterinarian, MTE Department of Timber Extraction, MOECAF

3Administration, MTE Department of Timber Extraction, MOECAF

Corresponding author’semail: This email address is being protected from spambots. You need JavaScript enabled to view it.



Presently there are 2940 elephants in the Myanma Timber Enterprise (MTE) in Myanmar. All of these elephants are owned by thegovernment and distributed around the country. Some elephants are utilized in logging and for carrying baggage from one camp to another during the rainyseason. In addition, some captive elephants in the country are privately owned and used in logging by private timber companies.

According to MTE records, the youngest femaleto give birthwas8 years old, and the oldest elephant gave birth at 46 years old. Some femaleshave givenbirth to more than six calves in their lifetime.  On rare occasions females have suffered cervico-vaginal prolapsed problems.

During the last decade, MTE lost three female elephants due to a prolapsed vagina. As MTE field veterinarians, we tried to save those elephants but gave up due to a lack of experiences and limited techniques and knowledge of surgery in those cases.

The female elephant (Ma-3945) Myint Ngae, 47 years old, suffered a prolapsed starting ten years ago. At the beginning, the prolapse in the perineal regioncaused a bulge that was 4 inches in diameter, but it got larger year by year. Then the bulge in the perineal region increased to about 22 inches in diameter. This prolapsed was determined due to cervico vaginal prolapsed because we found out bladder and urine in the field of Ultrasound.

Before surgery, the condition of the elephant was fit, fair, and free from any injuries on the body according to MTE method. This elephant could urinate althoughit was sometimes difficult for her. However the defecation was normal. Antibiotics and tetanus toxoid (ATT) were given preventatively (Table 1). Before surgery the elephant was eating, sleeping, and moving well.


Surgery process

Cleaning and disinfection process

This is an important process for surgery. Before starting, we first cleaned all dirty matters with fresh water and shaved the surgery site. We used disinfectants soap and water and 2% tincture of iodine.




General and local anesthesia

Calculated body weight of elephant was 2516kg based on chest grith by using formular (18 HG-3336), general anesthesia we used a combination of Xylazine (2%) and Ketamine. At the beginning, we gave 6 ml Xylazine (2%) (139.32 mg) combined with 1 ml Ketamine (50 mg) intramuscularly. After 10 minutes, we gave again 23.32 mg Xylazine intravenously into the ear vein. The elephant was sedatedand showed relaxed vulva and dropping of the clitoris, and very slow movement of trunk and ears. We used a local anesthetic, lidocaine, on the line of incision.  During the operation, we gave lidocaine along the incision line.


Surgery on the bulge 

Before surgery we checked the area byultrasound and saw a lot of fluid inside the bulge. We chose adorso-ventral incision line approximately 7 inches lateral from the perineal midline, near the right hind leg (about the area over the semimembranosus and semitendinosus muscle), because we wanted to avoid contamination of feces after surgery. The elephant stood quietly without showing any distress. We found some fascial layer and small blood vessels and avoided much bleeding. 

Finally we found the prolapsed vagina inside the vestibule. The bulge of the prolapsed vagina inside the vestibule was large and the bottom of this bulge was hard. We tried to find the fluid inside the bulge; luckily we found a hole and felt the fluid inside the bulge. 

We then inserted a plastic tube (about 1/4 inch diameter) and drained the fluid. The fluid was combined with urine and transudate. But luckily there wasno adhesion and not a lot of pus. Then we changed the plastictube to a larger size (1/2 inch) and drained the area again. We found some small stones came out with the fluid, and the size of the bulge was reducing. Finally, the bulge was quite small and we were able to reposition it through the pelvic inlet (apertura pelvis) and back into the normal position.

After pushing back the cervix and vagina, we applied a pad to apply pressure from the outside to help prevent re-occurrence of the prolapse and thus support the area while it healed. The pad is made with foamand wood connected with ropes and tied on the body of the elephant. The condition of the elephant was quite good after surgery.




First we very carefully closed the layer of vestibule, the fascial and muscle layer by continuous suture. Here we used absorbable catgut. The skin was closed by continuous nylon sutures in a mattress pattern. During suturing, we applied antibiotic powder (Cicatrin powder) in each layer. We applied antibiotic ointmenton the line of incision.

After surgery

The elephant defecated and urinated normally after the surgery. We provided intensive care at the elephant camp after surgeryand checked her blood profile (Table 2). We checked the ropes and pad on the body of elephant.


In past MTE records, some female elephants had died due to this kind of serious condition. This is now the first time in MTE that this type of condition has been successfully managed surgically. Everybody was excited for their field of veterinary medicine and for elephants that finally we were successful and had acquired very useful experience. Through this case we can continue to develop our skills in a positive manner for the future. As field veterinarians, we don’t have fancy equipment but we have good will, and a passion and attachment to our elephants. Hence, now we think that we can save our elephants and keep them free from distress. After surgery, nearly one month, the healing on incision was quite good and will leave all the ropes on the body of elephant.


We would like thank theinternational experts from outside Myanmar for providing comments and usefulcriticismsofthis surgery. Thesecriticismswerevery valuable for us during the surgery. Finally, we would like to say thank you deeply to HE Minister, tothe Permanent Secretary of the Ministry of Environmental Conservation and Forestry (MOECAF),to theManaging Director, and to the General Manager (Extraction) of MTE for their kind permission to do this surgery.

 Table 1. Pre and post operative medication 

 ** antipain drug


*   Supportive treatment


Note:   We gave antibiotics one week apart. 


Table 2 Before and after operation blood profile of elephant

Before operation


  After operation


 PCV = pack cell value

TP = Total plasma protein

Hgb= Heamoglobin

ESR= Ethrocyte Sedimentation Rate

N = Neutrophil

L= Lymphocytes

M= Monocyte

E = Eosinophil 

B = Basophil


Congratulatory Ceremony Held at Extraction Department Head Office

This occussion of elephant surgery is the first time in MTE's history and it is a great success for MTE especially Extraction Department. To congratulate this success, with the kind permission from General Manager (Extraction), Extraction Department held a congratulatory ceremony at its Head Office for the  participants in this elephant surgery. 



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