Pope Leo to undergo lung surgery: Who runs Vatican when pope is in hospital?

Pope Leo XIV is scheduled to have a surgery for removal of a small nodule from one of his lungs on Tuesday, October 13, 2026. This raises the question: who’ll take charge and oversee operations at the Vatican during the Pope’s absence?

The answer is nobody replaces him.

Unlike a president or prime minister, the pope does not have a deputy who automatically assumes his powers when he is hospitalised or temporarily unable to work.

The Vatican’s day-to-day administration can continue without him, but decisions that specifically require papal approval have to wait until he is able to deal with them again.

That arrangement will come into focus this week as the 71-year-old first American pope prepares for surgery after doctors discovered the growth of a small nodule during a routine health check.

The pope said Sunday that the nodule had been caught early and was “well-contained.” The Vatican expects his recovery to take about a week, although it has not said exactly when the operation will be carried out.

Leo showed little sign of slowing down on Monday.

He went ahead with seven previously scheduled meetings at the Vatican, including meetings with visiting bishops and was heard speaking clearly during an appearance with members of a Rome-based charity group.

His hospital stay could still affect some major events.

A Mass scheduled for Wednesday in St Peter’s Square remains on the calendar, but the Vatican has not confirmed whether Leo will be able to attend. A cardinal could lead the service in his absence.

The pope’s decision to disclose the surgery beforehand has also stood out at the Vatican.

His predecessor, Pope Francis, was hospitalised several times during his later years but his hospital visits were not usually announced in advance.