Pope Leo to undergo surgery to remove lung nodule today

Pope Leo was admitted to Rome’s Gemelli hospital ahead of surgery later in the day to remove a lung nodule, an operation that experts say will determine whether the lesion is malignant and if other treatment is needed. Photo (file picture): Alberto Pizzoli/Pool Photo via AP

Pope Leo was admitted to Rome’s Gemelli hospital ahead of surgery later in the day to remove a lung nodule, an operation that experts say will determine whether the lesion is malignant and if other treatment is needed.

After the quick drive from the Vatican on Tuesday, the Pope walked into the hospital through the main entrance and waved to dozens of well-wishers who had gathered to greet him.

The Vatican said the surgery would be performed later in the afternoon by a team led by Gemelli’s chief thoracic surgeon, Dr Stefano Margaritora.

The 71-year-old American pontiff has offered a rare level of transparency about the first publicly disclosed major health problem of his 17-month papacy.

He revealed the discovery of the small, localised nodule during his Sunday noon prayer and announced that he would have it removed.

Oncologists say even if the nodule turns out to be cancerous, Leo’s prognosis is “excellent” since it will have been removed at an early stage.

The surgery, which is usually performed under general anaesthesia, will require a week-long hospital stay and the Vatican on Monday cancelled all Leo’s audiences until October 20.

“These are things that can be treated very well, if the words he used reflect the clinical situation,” said Dr Lorenzo Spaggiari, director of thoracic surgery at the European Institute of Oncology, or EIO, in Milan, who is not involved in the pope’s care but knows the team at Gemelli.

A churchman who saw Leo on Monday, Tokyo cardinal Kikuchi Tsutomu, said Leo told him he felt fine and decided to have the surgery immediately to avoid altering his upcoming travel plans to Latin America.

But the decision clearly came as a surprise: While Gemelli has a specific papal apartment that past popes have used, complete with a private chapel on the tenth floor, Leo will actually be staying in a nearby room since the papal apartment is currently undergoing renovations, according to the Vatican press office.

Dr Spaggiari said he expected the team at Gemelli would perform a biopsy to determine whether Leo has lung cancer followed by the removal of a section or lobe of the lung where the nodule is located.

Both could be done using robotic techniques, and could be performed consecutively, under the same anaesthesia, with different specialist teams, Dr Spaggiari said.

A sophisticated robotic bronchoscopy technology called ION allows a biopsy on nodules as small as three millimetres, De Spaggiari said.

Both the Gemelli and the EIO have the technology, which has been available in Italy for just two years.

Gemelli also has robotic surgical technology, allowing the operation to remove the nodule to proceed “using a minimally invasive technique”, he said.

The technique involves the surgeon making four small incisions in the chest through which the instruments of the so-called da Vinci robot are inserted, he said.

The surgeon then controls the robotic arms looking at a screen providing high-definition, 3D views of the surgical site.

“It’s a very well-established technology. This is something we have been doing for 20 years,” he said.

It was not known for certain what technique would be used on Leo.

Gemelli has documented using both robotic procedures to diagnose and operate in under four hours.

The biopsy risk is “virtually zero”, while the surgical risk is very small, carrying a 0.6% to 0.8% mortality rate for patients in otherwise good health with good heart and lung function, Dr Spaggiari said.

During the surgery, doctors would also remove lymph nodes that drain the segment or lobe.

“If all those lymph nodes turn out to be negative, so stage one, then the outlook is very good”, he said, adding that no other treatment would be necessary.

The nodule was discovered during regular checks, the Vatican has said.

“I think he has had a bit of luck. They found something that was asymptomatic — a lung nodule, possibly a tumour. He might call it something else; we call it luck,” he said.

EIO advises patients not to fly for three weeks after surgery — which would give the pope just the interval needed to make his planned November 6-17 trip to Uruguay, Argentina and Peru, depending on his recovery.

The current itinerary for the trip is ambitious and the longest of his papacy to date, calling for Leo to clock just over 31,000km on a dozen flights and two helicopter rides, and a significant altitude change in Peru.