Pope Leo XIV Admitted to Gemelli Hospital for Surgery to Remove Lung Nodule

Pope Leo XIV walked through the main entrance of Rome's Gemelli hospital on Tuesday, after a short drive from the Vatican, and waved to the few dozen well-wishers who had gathered to see him arrive. Later that afternoon he was due to undergo surgery to remove a nodule from his lung, an operation that will show whether the lesion is malignant and whether he needs further treatment.

The Vatican said the operation would be performed by a team led by Dr. Stefano Margaritora, Gemelli's chief thoracic surgeon. The pope is 71, and this is the first publicly disclosed major health problem of his 17-month papacy. He has been unusually open about it. During his Sunday noon prayer he told the public that a small, localized nodule had been found and that he would have it removed. The Vatican has said it turned up during regular checks. On Monday it canceled all of his audiences through Oct. 20.

The surgery is usually done under general anesthesia and requires about a week in the hospital. Oncologists say that even if the nodule proves cancerous, his prognosis would be excellent, because it would have been removed at an early stage. Dr. Lorenzo Spaggiari, director of thoracic surgery at the European Institute of Oncology in Milan, is not involved in the pope's care but knows the Gemelli team. He said the matter can be treated very well if the pope's words reflect the clinical situation. He called the timing lucky: the nodule caused no symptoms and was found anyway.

Spaggiari expects the team to perform a biopsy first, to establish whether Leo has lung cancer, and then to remove the section or lobe of lung holding the nodule. Both steps could be done robotically, back to back under one anesthesia, by different specialist teams. A robotic bronchoscopy system called ION can biopsy nodules as small as 3 millimeters, and both Gemelli and his own institute have it; it has been available in Italy for only two years. For the removal, Gemelli's da Vinci surgical robot lets the surgeon work through four small chest incisions while watching a high-definition 3D screen. Spaggiari said the technology has been in use for 20 years. Which technique will actually be used on the pope was not known for certain, though Gemelli has documented doing both robotic procedures, diagnosis and operation, in under four hours.

He put the biopsy risk at virtually zero. Surgical mortality is 0.6% to 0.8% for patients in otherwise good health with good heart and lung function. Surgeons would also take out the lymph nodes draining the affected segment or lobe. If all of them test negative, which means stage one, Spaggiari said the outlook is very good and no other treatment would be needed.

The decision to operate right away appears to have been sudden. Gemelli keeps a papal apartment with a private chapel on the 10th floor, used by earlier popes, but it is being renovated, so Leo will stay in a nearby room, the Vatican press office said. Cardinal Kikuchi Tsutomu, the Tokyo archbishop who also heads Caritas Internationalis, saw the pope on Monday. He wrote on the Tokyo archdiocese's Facebook page that Leo felt no different than usual and chose early surgery so as not to change plans for overseas trips, adding that it was not an emergency and there was no need to worry.

Those plans are demanding. Leo is scheduled to travel Nov. 6-17 to Uruguay, Argentina and Peru, the longest trip of his papacy: just over 31,000 kilometers on a dozen flights and two helicopter rides, with a significant altitude change in Peru. The European Institute of Oncology advises patients not to fly for three weeks after this surgery, which leaves just enough time, depending on his recovery. Spaggiari said the pope is in excellent hands at Gemelli.

What to watch now is the pathology: whether the nodule is malignant, whether the lymph nodes are clear, and how quickly he recovers ahead of the November trip.