Pope John Paul II (search) was recovering Friday after undergoing a successful tracheotomy to assist him with breathing difficulties on Thursday.

The Vatican (search) issued a statement saying doctors at the Gemelli Polyclinic (search) successfully operated on the pope after he gave his consent. The pope was back in his hospital room and breathing without the help of a respirator, Italian news agency ANSA reported.

The Vatican characterized the procedure as elective — underscoring that it was not done as an emergency measure. It was the second time in a month that the pope needed to be hospitalized for flu symptoms.

An aide to Italian Premier Silvio Berlusconi said the pope was conscious and "serene" after the operation. The pope raised his hand and attempted to speak with doctors but was told not to try, Cabinet Undersecretary Gianni Letta told reporters at Gemelli Polyclinic Hospital in Rome.

The procedure, in which a hole is made in the throat and a tube is inserted, was performed to help the pontiff with his breathing. It is not seen as threatening and usually is left in for two or three days. There were conflicting reports over whether the pontiff was sedated under general or local anesthesia during the operation.

Medical experts said the pope's needing a respirator was a serious development, especially considering the fact that he'd recently been released from the hospital after experiencing similar symptoms.

"The fact that he is on a respirator is not good. The fact that he was readmitted so quickly is not good. All this suggests there's a serious problem," said Dr. Michael Kaplitt, a Parkinson's disease expert at New York Presbyterian Hospital/Weill Cornell Medical Center.

The Vatican said the operation took 30 minutes and was finished "in a positive way." However, the tracheotomy (search) will have serious consequences for the pope's abilities to carry out his duties. The operation will prevent him from speaking for an extended period of time and probably require a long hospital stay.

The 84-year-old pontiff was rushed to the hospital at 10:45 a.m. Thursday after suffering from fever and congestion from a recurrence of the flu, officials said. A day earlier, he had made his longest public appearance since being discharged from the clinic two weeks ago.

Aides said the pope had a fever, congestion and had suffered a recurrence of breathing problems. The pope also has Parkinson's disease (search) and crippling knee and hip ailments.

Medical experts who have not examined the pope but are familiar with elderly Parkinson's patients say his symptoms appeared to be consistent with pneumonia (search).

"It appears the pope is suffering from pneumonia, likely a bacterial pneumonia, a serious problem for a man of his age with Parkinson's," said Dr. Barbara Paris, chairwoman of geriatrics and vice-chairwoman of Medicine at Maimonides Medical Center in New York.

The Vatican declined to respond to outside medical speculation about the pope's condition.

A medical health bulletin was to be issued Friday morning. Thursday's hospitalization was the pope's eighth since his election in 1978, and his illness drew concern from around the world.

President Bush, flying back to the United States after a trip to Europe, wished the pope a rapid return to health.

"On behalf of all Americans, Laura and I send our heartfelt best wishes to Pope John Paul II. The Holy Father is in our thoughts and prayers, and we wish him a speedy recovery and return to the service of his church and of all humanity."

In the pope's hometown of Wadowice, in southern Poland, worshippers offered prayers at an afternoon Mass in St. Mary's church, where the young Karol Wojtyla was baptized.

"This is very emotional moment for me," said Zdzislaw Szczur, 54, the head of the Wadowice branch of Solidarity, the trade union best known abroad for its struggle in the 1980s to bring down communism. "His suffering really moves me. It's all God's providence now."

Tourists and pilgrims in St. Peter's Square expressed alarm.

"I'm sure he wants to return to the Vatican because he has spent so much time there," said Ornella Lisandrello, 29, an Italian physician. "I'm sure he would like to die at the Vatican."

The pope's breathing problems can complicate the swallowing difficulties characteristic of Parkinson's disease. The lack of coordination of the muscles involved make it easy for food or saliva to get into the lungs. That can cause pneumonia and is one of the most common causes of death among Parkinson's patients.

Doctors sometimes bypass the throat by inserting a feeding tube directly into the stomach, both to help patients who have difficulty eating and to help prevent food going down to the lungs.

The muscle problems and the pope's stooped posture also could make it difficult for him to head off infections by mustering a powerful enough cough to shake mucus out of the lungs.

Rome has been particularly cold, wet and windy in recent days. The pope has twice appeared at his open studio window to address crowds in St. Peter's Square (search) since his Feb. 10 discharge from the hospital.

Because of his ailments, there has long been speculation that John Paul might consider resigning. That debate was fueled during his earlier hospitalization when Cardinal Sodano declined to rule out that possibility, saying it was up to the pope's "conscience."

The Gemelli Polyclinic has taken in John Paul so often that it has been dubbed by the Italian press as "The Third Vatican," after the seat of the Holy See on St. Peter's Square and the pope's summer residence in the town of Castel Gandolfo.

The hospital has a suite on the 10th floor that includes a chapel, kitchen and sleeping quarters for his longtime aide.

In 1981, the pope was shot in the abdomen and hand in a shooting attack by Turkish gunman Mehmet Ali Agca in St. Peter's Square. He spent 20 days at Gemelli after undergoing surgery.

The Gemelli clinic was under tight security Thursday.

The Associated Press contributed to this report.