Still-Unconscious Sharon Undergoes Surgery

Prime Minister Ariel Sharon on Saturday survived his latest medical crisis -- one that has served, somewhat poignantly, to underscore the degree to which the Israeli political torch has already passed to his successor, Ehud Olmert.

The 77-year-old leader, who has been comatose since suffering a massive stroke more than five weeks ago, was said by doctors to be out of immediate danger after emergency surgery Saturday in which about 1 1/2 feet of his large intestine was removed.

Shlomo Mor-Yosef, director of Hadassah University Medical Center at Ein Kerem, told reporters at the hospital that Sharon, who has been unconscious since a cerebral hemorrhage Jan. 4, had come safely through four hours of surgery.

“Initially, it seemed his life was threatened,” said Mor-Yosef, addressing reporters as he stood in front of the blue-and-white logo of Hadassah University Medical Center, Israel’s premier hospital, where Sharon has been under treatment since the immediate aftermath of his stroke.

Although the development occurred on the Jewish Sabbath, when much of Israel is shut down, word spread quickly of the sudden deterioration in Sharon’s condition. Aides and family members rushed to the hospital, on a rocky hillside on Jerusalem’s outskirts, and a crowd of anxious well-wishers gathered in the parking lot.

“He’s just so strong,” said Mariah Goldman, who was shopping for groceries in central Jerusalem and keeping abreast of Sharon’s condition via a TV set near the checkout counter. “You somehow think that even now, nothing can happen to him.”

Sharon has shown little sign he will emerge from his coma, other than moving his limbs in response to pain stimulus. Doctors last month performed a tracheotomy to help him breathe with the aid of a respirator, and on Feb. 1 inserted a feeding tube -- another sign that his condition was considered one of long-term incapacitation.

Despite the initial shock of Sharon’s disappearance from political life, the speed of events in this country dictated that his successor could not remain a mere figurehead for long. Olmert, who was Sharon’s deputy and among his closest confidants, stepped in as interim prime minister on the night he was stricken, and almost immediately began dealing with challenges including the Jan. 25 victory of the militant group Hamas in Palestinian parliamentary elections.

Olmert has assumed the leadership of Kadima, the centrist party Sharon founded weeks before his stroke, in the campaign for Israel’s March 28 election. The party, whose platform calls for the creation of a Palestinian state, holds a commanding lead in the polls.

However, the right-wing Likud Party, of which Sharon was a founding member in the 1970s, has been seeking to position itself as the only political entity with the resolve to confront Hamas and other threats.

In an acknowledgment that Sharon had departed the political stage, his party was unable to give him even a symbolic place on its slate of candidates in the coming election. Under the law, the Israeli leader would have had to be able to sign papers attesting to his candidacy.

Since slipping into a coma, the prime minister has undergone regular brain scans to check for signs of either new problems or possible recovery. The latest, conducted last week, showed no change.

Hospital director Mor-Yosef said an abdominal scan on Saturday morning indicated a blockage in blood flow to the area and the resulting deterioration of some tissue, and doctors decided to operate immediately.

Such a condition, the hospital director said, is not unusual in comatose patients -- but can be difficult to diagnose because the patient does not show obvious signs of distress.

“Of course the prime minister can’t be asked how he’s feeling, whether he’s feeling any pain,” Mor-Yosef said.

Although the immediate crisis passed, Sharon’s longer-term prognosis remained grim, the hospital spokesman said.

“His present condition is difficult -- stable, critical -- and there is no immediate danger to the life of Ariel Sharon, the prime minister,” Mof-Yosef said somberly. But he added that “these changes

Sharon’s massive stroke came on the eve of a planned procedure to correct a congenital heart defect. That defect, a tiny hole in one of his heart’s upper chambers, was thought to have contributed to a minor stroke Dec. 18, by allowing a blood clot to travel to his brain.

Decisions made in the course of the prime minister’s medical treatment have aroused considerable controversy in Israel. Some doctors not involved in his case expressed astonishment that he was allowed to return to work so soon after the first stroke.

Others have sharply questioned whether the prime minister should have been treated with blood thinners, which can increase the risk of a massive cerebral hemorrhage like the one he subsequently suffered.

There was also serious debate about the decision to allow Sharon to spend time at his Negev ranch, which was more than an hour’s journey from Hadassah. On the night of his stroke, Sharon was transported to the hospital by ambulance rather than by airlift.

Medical experts have expressed strong doubts as to whether Sharon will regain any meaningful degree of cognitive activity. The prime minister underwent more than eight hours of complex emergency surgery following the cerebral hemorrhage, and some outside experts said afterward that such measures, while lifesaving, were unlikely to yield any prospects for a return to normal life.

In the months before his stroke, Sharon shocked his former core constituency -- Jewish settlers -- by presiding over an uprooting of the Jewish settlements of the Gaza Strip. The Israeli leader believed that the seaside territory had come to represent too large a security risk and demographic liability.

In Gaza, about 9,000 Jewish settlers lived among more than 1.3 million Palestinians, and huge military resources were devoted to protecting them.

Sharon’s interim successor, Olmert, has indicated that he sees future pullbacks from remote West Bank settlements as a means of drawing secure borders for Israel. But he also says Israel will seek to retain large settlement blocs that lie close to the so-called Green Line, the 1967 armistice line.