Pope comes out of hours-long surgery with no complications

Pope Francis underwent successful surgery Wednesday to repair a hernia in his abdominal wall, the latest malady to befall the 86-year-old pontiff who had part of his colon removed two years ago.

Francis underwent surgery to repair a hernia in his abdominal wall

The pope, and older man, is seen seated in white vestments and wearing a large cross atop his clothing.
Pope Francis is shown on Wednesday in St. Peter's Square. The Vatican said Francis would convalesce at Rome's Gemelli hospital after a successful surgery to repair a hernia. (Andrew Medichini/The Associated Press)

Pope Francis underwent successful surgery Wednesday to repair a hernia in his abdominal wall, the latest malady to befall the 86-year-old pontiff who had part of his colon removed two years ago.

The Vatican said there were no complications during the three-hour surgery, which required Francis to be under general anesthesia. Soon after the procedure, the surgeon who performed the operation said the pope was awake and that the hernia was fixed.

The pontiff was expected to remain at Rome's Gemelli hospital for several days. As a precaution, all papal audiences were cancelled through June 18, the Vatican said.

Dr. Sergio Alfieri, director of abdominal and endocrine sciences at Gemelli, who also performed the Pope's 2021 colon surgery, said Francis was alert and even joking. "When will we do the third one?" he quoted Francis as saying.

During the operation, doctors removed the adhesions, or internal scarring, that had caused the Pope pain in recent months, said Alfieri, who also revealed that Francis had undergone previously undisclosed abdominal surgery sometime before 2013 in Argentina.

Balding man in white coat speaks into a microphone
Dr. Sergio Alfieri told reporters after the surgery that the pope suffered no complications and was alert and even joking with him. (Remo Casilli/Reuters)

Intestinal surgery 2 years ago

In the most recent operation, a prosthetic mesh was placed in the abdominal wall to repair the hernia, Alfieri said.

While hernia operations are rarely performed on an emergency basis, the procedure appeared somewhat urgent, scheduled just a day after Francis went to the hospital for tests. The pontiff's doctors no doubt also wanted to give him ample time for recovery ahead of a busy travel schedule later this summer.

The Pope was suffering from a hernia that formed over a previous scar, presumably from his 2021 colon surgery. Experts said the formation of the hernia, called a laparocele, is a known complication from intestinal surgery. The concern is that a portion of his intestine may have bulged through the tear and become trapped.

At three hours, the Pope's procedure was considerably longer than the standard 60 to 90 minutes doctors say the operation usually takes.

Spending more time under anesthesia, coupled with being on a ventilator for so long — in someone who has lost part of one lung as a young man — could put Francis at risk of breathing complications or a longer-than-expected recovery time.

It was also unclear if doctors removed any more sections of the Pope's colon, which may have been made necessary by the hernia.

Francis went to the hospital for previously unannounced tests Tuesday, returned to the Vatican and presided over his audience Wednesday morning, but then went straight to Gemelli for the procedure afterward.

"When the intestines are trapped, the blood supply to the bowel is compromised. And if you don't take care of it, the bowel will die, and you will have gangrenous intestines," said Dr. Walter Longo, chief of colon and rectal surgery at Yale University School of Medicine.

He said Francis should be OK after a few weeks of recovery, but he noted that the aging Pope is already frail. "There's the risk of going through surgery, operating on a fragile individual, but if he can get through it, he will be fine," he said.

The Pope remained in charge of the Vatican and the 1.3-billion strong Roman Catholic Church, even while unconscious and in the hospital, according to canon law.

The pope extends his right hand to touch a baby that has been lifted in front of him.
The 86-year-old pontiff appeared in good form on Wednesday morning at his audience in St. Peter's Square. (Andrew Medichini/The Associated Press)

Francis had come out of the 2021 surgery saying he could eat whatever he wanted, but he lamented that he hadn't responded well to the general anesthetic used in the longer-than-expected procedure. That reaction in part explained his refusal to have surgery to repair strained knee ligaments that have forced him to use a wheelchair and walker for more than a year.

The Argentine Pope had part of one lung removed when he was a young man. He also suffers from sciatica nerve pain.

In late March, Francis spent three days at Gemelli for an acute case of bronchitis, during which he was treated with intravenous antibiotics. He emerged April 1 saying "Still alive!"

Recovery period essential, doctor says

Dr. Manish Chand, a professor of surgery at University College London who specializes in colorectal surgery, said the operation Francis underwent on Wednesday is usually straightforward.

In the procedure, a surgeon typically frees the trapped intestine and then repairs the hernia and implants a prosthetic, most likely a piece of mesh.

Chand said the greatest issue afterwards will be pain management and making sure the wound heals properly.

"In the first six weeks after this type of surgery, you're at risk of getting a recurrence again," he said. To avoid that, patients are advised not to do anything strenuous.

The Vatican had recently confirmed a travel-filled August, when the Holy See and Italy are usually on vacation, with a four-day visit to Portugal the first week of August and a similarly long trip to Mongolia starting Aug. 31.

In a sign that the trips were very much on, the Vatican on Tuesday released the planned itinerary for Francis's visit to Portugal for World Youth Day events from Aug. 2-6.

The itinerary confirms a typically busy schedule that includes all the protocol meetings of an official state visit, plus multiple events with young people and a day trip to the Marian shrine at Fatima.