Pope John Paul's tracheotomy was a straightforward procedure but medical experts said today the need for the emergency surgery was a further sign of his deteriorating condition.
Vatican spokesman Joaquin Navarro Valls (center) listens to Cesare Catananti, director of Rome's Gemelli hospital (right) and the hospital's Emergency director Rodolfo Proietti (left) as they stand on a 10th floor balcony of the Gemelli Polyclinic hospital.
Surgeons made an incision into the trachea or windpipe of the 84-year-old Pontiff in a short operation yesterday to remove phlegm and help him breathe after a relapse of influenza.
A Vatican spokesman, Mr Joaquin Navarro-Valls, said the Pontiff's heart and blood circulation remained good and he had no bronchial pneumonia infection, a possible complication of the tracheotomy performed on him yesterday to ease his breathing problems.
An aide to Premier Silvio Berlusconi said the pontiff was conscious and "serene" after yesterday's surgery.
Medical experts said the operation to open the Pope's throat showed he was extremely ill.
It is the second hospital stay for the leader of the world's Catholics this month. "The tracheotomy doesn't affect his prognosis at all except that it means things are worse this time than they were the last," said Dr Michael Bridger, an ear, nose and throat specialist at Derriford Hospital in Plymouth, England.
"Sometimes these things keep recurring and each time people never quite recover to the point they were before. There is a stepwise deterioration and this is a further step," he told Reuters. By Friday, the Pontiff was reported to be breathing unaided but specialists said he might not be able to speak for some time and even then he may need a special device to help him form sounds.
The Pope's frailty and his Parkinson's disease, which affects the muscles of the throat and chest, will also influence his recovery, according to the experts. "Slurred speech and loss of the force of voice are common components of Parkinson's disease," said Professor Peter Jenner, of King's College London who is a specialist in the disease.
The tracheotomy could further impair his ability to speak, he added.
In addition to aiding the Pope's breathing, the surgery would have allowed doctors to clear secretions from his chest - which the Pontiff could not do himself.
"His age, his hunched posture and his muscular weakness which goes with Parkinson's disease all predispose him to what is in medical terms called retained secretions," Dr Bridger said.
If the secretions are not removed the fear is that the Pope could develop pneumonia. "Bronchial pneumonia is a very common cause of death in people with Parkinson's disease because the chest muscles just don't work and you cannot get fluid out of the lungs," said Prof Jenner.
The once athletic Pope also suffers from arthritis which makes it difficult for him to walk or stand. He nearly died when he was wounded in the stomach and hands during an assassination attempt in 1981.
Agencies