Pope Francis was expected to return to the Vatican after he was released from a Rome hospital on Friday following abdominal surgery for a hernia, the third time in two years that the 86-year-old pontiff has been hospitalized.

Francis left the Policlinico A. Gemelli hospital around 8:45, nine days after surgeons operated on what is known as an incisional hernia, typically the consequence of previous operations, that had been causing painful intestinal blockages.

The pope smiled as he left the hospital in a wheelchair along a sidewalk lined with dozens of well-wishers. Reporters and photographers jostled for his attention, but the pope did not stop. Before getting into the front seat of his car, he shook hands with the surgeon who had operated him and waved to the crowd.

A reporter for the state broadcaster RAI said she had asked the pope how he was, and he told her: “Still alive.”

Doctors have cautioned that Francis should avoid exerting himself in the coming weeks to ensure that his wounds heal properly. He is scheduled to visit Portugal for World Youth Day events from Aug. 2 to 6, and then Mongolia from Aug. 31 to Sept. 4.

On Saturday, Sergio Alfieri, the director of abdominal and endocrine sciences at the Gemelli hospital who carried out the operation, told reporters that doctors had advised Francis not to rush his recovery and to remain in the hospital until he could properly heal, otherwise he risked going under the knife again.

Francis’ nine-day recovery proceeded regularly, according to daily Vatican statements, and the pope gradually increased his activities. On Thursday, Francis met with the hospital’s medical team and administrators “in a sign of gratitude.”

Using a wheelchair, Francis also visited young patients in the pediatric cancer and child neurosurgery ward to thank them for the “numerous letters, drawings and messages” they had sent him during his stay.

The pope has been dealing with various medical issues, and the abdominal surgery represented the second time that Francis has faced a significant health matter during his 10-year papacy. He had roughly 13 inches of his large intestine removed in 2021 because of what the Vatican said was inflammation that caused a narrowing of his colon.

More recently, he was hospitalized in late March for bronchitis at the Gemelli, where popes are often treated. He also has a problem with his right knee and recurrent episodes of sciatica, a nerve condition that causes back, hip and leg pain.

Francis said at the beginning of his pontificate that he envisioned serving only a few years, and he has said since that he would resign if failing health made it impossible for him to run the church.

Soon after he was elected, he praised his predecessor, Benedict XVI, the first pope in almost 600 years to resign, for having the courage to step down. Benedict died in December.

But after his surgery in 2021, Francis told a Spanish-language radio station that he had never thought about quitting while suffering from poor health. He said this year that he viewed the pontificate as a lifelong mission, telling a group of Jesuits in the Democratic Republic of Congo that he thought “the pope’s ministry is ad vitam,” using the Latin term “for life.”

In an interview in January, Francis told The Associated Press that he was in good shape for his age. “I’m in good health. For my age, I’m normal,” he said, adding, “I might die tomorrow, but it’s under control. I’m in good health.”

The Vatican said that the pope’s audiences would be canceled until June 18 as a precautionary measure.

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