Flanker Mauro Bergamasco of Italy's can miss the whole six nation after undergoing shoulder surgery on Thursday.
Earlier this month after the defeat from Argentina The Stade Francais player was ruled out although he tried to be fit for last Saturday's loss to Australia, doctors realised an operation was the only option.
Bergamasco participation in any of the games is in serious doubt as the Italian rugby federation said in a statement Bergamasco was likely to return in around four months and with the Six Nations finishing on March 19.
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