(PIX11) — Pope Francis, now 86, did not react well to general anesthesia when he underwent surgery in 2021 to remove 13 inches of his large intestine.

That’s why he resisted an operation for a bad knee, choosing to get around with help from a cane or wheelchair. But the Holy Father really didn’t have a choice when it came to surgery Wednesday to repair an intestinal hernia.

“Occasionally, the wound will weaken or break down, and that is called an incisional hernia,” Dr. John Procaccino, Chief of Colon and Rectal Surgery at North Shore University Hospital in Manhasset, explained. “If a piece of the bowel pops into that, it can be choked off and strangulated, and that can be life-threatening.”

The pontiff appeared at his regular Wednesday audience in St. Peter’s Square, never letting on that he was heading straight to Gemelli Hospital for surgery.

The Vatican later reported the three-hour procedure went well “with no complications.”

This is the second time Pope Francis has been hospitalized since late March.  

He was treated for a serious bronchial infection in the spring and released just in time to celebrate Palm Sunday Mass.

As a young man, the pope lost part of one lung while living in his native Argentina.

It’s been ten years since Francis was elected leader of more than a billion Catholics.  

He replaced Pope Benedict, the first pontiff to resign in 600 years.

Benedict died earlier this year, and Francis presided over his funeral Mass.

Even though he was sedated, the Holy Father never turned over control of the Roman Catholic Church to a subordinate while in surgery.

“To repair a hernia, one must undergo general anesthesia,” Dr. Procaccino told PIX11 News.  “That requires a breathing machine to be breathing for you and that your muscles are paralyzed to allow the surgeon to repair the defect.”

The Vatican seems confident that Pope Francis will make a good recovery.

On Tuesday, it announced plans for Francis to make a four-day trip to Portugal in August for World Youth Day.