By Alan Atchison

The relationship between the University of Pennsylvania School of Veterinary Medicine and the Philadelphia Zoo has been a long-standing one, centered around the common thread of helping each other help animals in need. One recent case involved a zoo primate named “Demba,” a 34-year-old gorilla in need of a hysterectomy.

Demba was brought to the Philadelphia Zoo five years ago in hopes of starting a new line of gorillas. As she failed to conceive over time, however, zoo doctors became increasingly concerned. Upon further examination, Philadelphia Zoo veterinarian Keith Hinshaw discovered a benign tumor in Demba’s uterus. Clearly, any mating hopes now were out of the question, and the priority shifted solely to saving Demba’s life. To remove the tumor, Hinshaw requested the services of Dr. Sean Harbison, a human surgeon at Temple University Hospital, and Dr. David Holt, section chief of surgery and associate professor of surgery at the School.

 

 

 

 

Demba before surgery, under anesthesia.

 

 

“Keith contacted me and said they had a gorilla with an abdominal mass and asked if I would be prepared to come out,” said Holt, whose expertise mainly involved dogs and cats. For both Holt and Harbison, gorilla surgery was breaking new territory, as Harbison only performs surgery on humans. Holt believed such a move by Hinshaw was wise. “We thought that bringing in a human surgeon was important because the gorilla’s anatomy is obviously going to be much more like a human than it is like a dog or cat.”

Due to the doctors’ schedules, Holt didn’t get a chance to visit Demba prior to the surgery to learn more about her condition. He described his role during the surgery as that of an assistant, deferring most of the credit to others. Dr. Steve Mehler, a soft-tissue surgeon at the School, also assisted in the gorilla’s hysterectomy. The School was also represented by an anesthesia team consisting of Dr. Lin Klein of New Bolton Center, as well as residents Drs. Patrick Burns, Tamas Ambrisko, and Ben Brainard. The four took care of most of the preparatory work before the actual surgery took place.

“The anesthesia team had the gorilla anesthetized when Steve and I arrived,” Holt said. “One of the staff from the zoo prepped her. We did our regular scrub and organized the instruments. Once they were prepped, we draped and did the surgery.”

The beginning of the surgery proved to be the most difficult part for the surgeons, as gorilla skin generally is much tougher than the skin of humans, dogs, or cats--with a few exceptions. “Cats, if not neutered, can have very tough skin,” said Holt. “But the gorilla skin was tougher than most of the dog and cat skin that we deal with. We had to push a bit harder with the scalpel blade to get through the skin. But once we were through, it was pretty much like a regular exploratory abdominal procedure, similar to one we would perform for a dog or cat.”

One potential hazard was the threat of Demba losing too much blood during the procedure, though the surgical team took all the necessary precautions to keep such a situation from occurring. “We didn’t have a blood loss problem because we took our time and made sure we dealt with all the vessels, some of which were quite large,” he said.

The surgeons successfully removed Demba’s uterine tumor in just over an hour. Holt credited much of the success to Harbison, and described him as the unofficial leader of the team. “He was really great. He let us do quite a lot of the surgery and he just chipped in where he thought he needed to chip in. He was a really nice bloke to work with, he and his resident.”

In addition, Holt praised the staff of the Philadelphia Zoo and welcomed the chance to treat other species of animals there in the future. “They have a really good professional team,” said Holt. “The whole setup was very well run and it’s something I think we should stay involved with.”

Demba is expected to live a normal life now, despite the fact that she will never become pregnant. “The procedure itself went really well. I was very happy to have had the experience,” said Holt. “Demba did well and hopefully will be able to stay in the primate center for several years to come.”