ROME (AP) — Pope Francis underwent successful surgery Wednesday to remove intestinal scar tissue and repair an abdominal wall hernia, the latest ailment. To 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. The pope was expected to remain at the Gemelli Hospital in Rome for several days, and all papal masses were canceled until 18 June.

Dr. Sergio Alfieri, director of Abdominal Sciences and Endocrinology at Gemelli, who also performed Francis’ 2021 colon surgery, said the operation was a success. Shortly thereafter, the pope was up, alert, and even joking.

“When are we going to do the third?” Francis was quoted as saying.

During the operation, doctors removed internal adhesions or scarring in the intestines that had caused partial obstruction, in addition to pain in recent months. Alfieri revealed that Francis had had previous undisclosed abdominal surgeries sometime before 2013 in Argentina, which also left him with scars.

To repair a hernia that had formed over a previous scar, Alfieri said, a synthetic mesh was placed in the abdominal wall. He added that the Pope did not suffer from any other diseases, that the tissue removed was benign and that after he recovers, he should be fine.

No frightful bump, or distention, was found in the intestine through the hernia tear.

said Dr. Walter Longo, chief of colorectal surgery at Yale University School of Medicine, who was not involved in the surgery and commented after consulting the Vatican statement on the procedure.

Hernia operations are rarely performed in emergency situations, and Alfieri said the surgery was planned. Although not publicly announced, it appeared to be timed so that Francis would have plenty of time to recover before a busy travel schedule later this summer.

At three hours, Pope’s operation was much longer than the standard 60 to 90 minutes doctors say a hernia operation usually takes, but Alfieri noted that scar tissue from previous surgeries was completely removed.

Spending more time under anesthesia, along with staying on a ventilator for a long time — in someone who lost part of one lung as a young man — could put Pope at risk of breathing complications or a longer-than-expected recovery period, the experts said.

Francis remained in power From the Vatican and the 1.3 billion strong Catholic Church, even while unconscious and in hospital, according to canon law.

In July 2021, Francis spent 10 days at Gemelli to remove 33 cm (13 in) of his large intestine. In an interview with the Associated Press In January, Francis said it was the diverticulum, or bulges in the wall of the intestine, that pushed back the surgery.

After that surgery, Francis regretted that he did not respond well to general anesthesia. This reaction partly explained his refusal to undergo surgery to repair strained knee ligaments that had forced him to use a wheelchair and a walker for more than a year.

However, Alfieri said Francis did not have any adverse reactions to anesthesia in 2021 or Wednesday.

“It is clear that no one likes to have surgery and sleep because the moment we are put under water we lose consciousness,” he said at an evening press conference at the hospital, with the Vatican spokesman next to him. “But there was no physiological problem two years ago or today.”

Dr Manish Chand, a professor of surgery at University College London who specializes in colorectal surgery, said the biggest issue after that would be managing the pain and making sure the wound healed properly.

“In the first six weeks after this type of surgery, you are at risk of it happening again,” he said. To avoid this, patients are advised not to do anything strenuous.

Dr Robin Phillips, emeritus professor of colorectal surgery at Imperial College London, noted that abdominal surgery can also harm lung function.

Part of the Argentine pope’s lung was removed when he was a young man. In late March, Francis spent three days in Gemelli due to bronchitis He was treated with intravenous antibiotics. He appeared on April 1, saying “I’m still alive!”

“I suspect they’re doing it now because they’re worried it could become more complicated and result in an emergency operation, which would have more risks than leaving it alone or working now,” Phillips said.

After celebrating his weekly general audience on Wednesday, the pope was driven in his Fiat 500 from the Vatican shortly after 11 a.m. and arrived at Gemelli about 20 minutes later, escorted by police.

“The stay in the health facility will last several days to allow for a normal postoperative cycle and full functional recovery,” the Vatican said in a statement.

The pope had made a well-done appearance Wednesday morning to his audience in St. Peter’s Square, trolling the square in his shopping cart to greet the faithful. The Vatican said it had also held two meetings before that.

Francis has had a busy schedule lately, with multiple audiences each day. The Vatican recently confirmed that August is a travel-packed month, when the Holy See and Italy are usually on vacation. He is making a four-day visit to Portugal scheduled for the first week of August and a similarly long trip to Mongolia beginning on the 31st.

In a sign that the flights are still under way, the Vatican on Tuesday released the planned itinerary for Francis’ visit to Portugal for World Youth Day events from Aug. 2 to Aug. 6. Visit in addition to multiple events with young people and a day trip to the Marian Shrine in Fatima.

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Cheng reported from London.