When the team of medics pulling this huge hippo’s aching tooth say open wide, they are not kidding.

The 38-year-old Nile hippopotamus underwent the tricky procedure surrounded by a team of international medics after keepers spotted she was off her food.

Veterinary dentists at Warsaw Zoo, Poland, discovered she had a huge cavity in one tooth and there was no option but to extract it, according to the zoo.

The hippo – named Pelagia – became the focus of a massive team of surgeons, dentists, vets, anaesthetists and X-ray specialists for the challenging op.

Pictures from the procedure on 3rd June show how the team needed to construct a special steel scaffolding just to keep Pelagia’s jaws open for the extraction.

Warsaw Zoo said in a statement obtained by Newsflash: “Performing a procedure on such an exceptional patient like hippopotamus Pelagia is always a huge challenge, which is why a large international team of doctors and specialists was necessary.”

The zoo said that experts Dr Cobus Raath and Dr Aleksandr Semjonov gave Pelagia sedatives and led the procedure

The statement continued: “The first stage involved taking X-ray images to assess the situation by dental specialists.

“After taking X-ray images of the jaw, an examination of the oral cavity was performed to determine the likely location of the problem.

“This examination was conducted by Dr Gerhard Putter and Dr Katarzyna Jodkowska. The doctors selected one of the teeth that needed to be removed.”

The extraction was described as “complicated, lengthy, and requiring a great deal of effort from everyone involved”.

The zoo went on: “After ensuring that the entire tooth, including the roots, was removed, the gap was secured with a special dressing that we hope will remain in place long enough to protect the resulting hole and aid in the healing process.”

The medics monitored Pelagia’s heart during the operation and took blood samples for analysis.

The statement said: “The procedure provided our veterinary doctors with the opportunity to thoroughly examine the extraordinary patient, the hippo, in order to assess her health condition more accurately.”

Pelagia was then woken up after the op and was back on her feet 90 minutes later.

The zoo said: “The beginnings were shaky, but Pelagia showed that despite her age, she is an exceptionally strong hippopotamus.

“We hope that the procedure will bring the expected results, and that the recovery process will go smoothly.

“Pelagia will stay in the Hippo House for some time, surrounded by the care of loving keepers who will help her recover. If you happen to be inside, we kindly ask for silence and calmness so that our senior can peacefully regain her health. Please keep your fingers crossed for her.”

Hippos are listed as vulnerable on the International Union for Conservation of Nature’s (IUCN) Red List of Threatened Species.

The main challenges to their populations in the wild are poaching and war.