Israeli special forces backed by additional troops entered Gaza City’s Shifa Hospital overnight Tuesday to carry out a “precise and targeted operation” against Hamas terror infrastructure at the site.

The operation continued into the morning, with the Israel Defense Forces finding weapons and Hamas assets inside. At least five Hamas gunmen were killed by troops during a gun battle outside the hospital. No soldiers were hurt.

The Times of Israel was told there had been no “friction” between troops and patients and medical staff. Incubators for newborns, baby food, and medical supplies were brought by IDF tanks from Israel and delivered to Shifa, the military said.

“Medical teams and Arabic-speaking soldiers are on the ground to ensure that these supplies reach those in need” and that civilians are kept out of harm’s way, it added.

“We call upon all Hamas terrorists present in the hospital to surrender,” the military said.

News agency AFP cited a source inside the hospital as reporting that forces raced through the corridors and fired warning shots as they moved from room to room looking for gunmen. The army did not confirm the report.

The IDF has said the hospital serves as cover for the terror group’s fortified underground command center — though it is unclear what or who remains there since the military launched its ground offensive in northern Gaza. Hamas leadership is thought to have largely moved to the Strip’s south.

Witnesses have described conditions inside the hospital as dire, with medical procedures performed without anesthetic, families with scant food or water living in corridors, and the stench of decomposing corpses filling the air.

The army stressed that the military was “not overrunning” the hospital, asserting troops were conducting a “focused” operation “in a defined area” of the hospital.

Though Israel believes some of the 240 hostages captured by Gaza terrorists were housed at the hospital at one time, there is no indication of hostages currently being held there. However, the IDF believes the operation may bring intelligence information on the captives.

“Our goal is to bring [hostages] home. Our goal is to seek out Hamas wherever they are hiding,” Lt. Col. (res.) Peter Lerner told CNN.

Youssef Abul Reesh, an official from the Hamas-run health ministry inside the hospital, said he saw Israeli tanks inside the complex and “dozens of soldiers and commandos inside the emergency and reception buildings.”

An unnamed security official told Army Radio that the Israeli operation at the hospital will be widened if necessary, and implied that the military knows what it is going to find there.

“We are starting small, and the operation will expand as necessary,” the official said. “The entry of troops into Shifa is more of a media (optics) challenge than an operational one.”

The IDF has been urging the hospital to evacuate since the start of the war, but authorities refused. Israel has also tried to coordinate the evacuation of the more seriously wounded patients and premature babies.

In recent days, as Israeli forces closed in on the compound amid gunfights with gunmen, thousands of the displaced people who had taken shelter in the hospital grounds took advantage of daily safe routes to evacuate to southern Gaza. Many patients who were able to also left, as did some medical staff.

The United Nations has estimated that at least 2,300 people — patients, staff, and displaced civilians — remain inside and may be unable to escape because of the fierce fighting in the area.

The IDF also announced early Wednesday that two officers had been killed in fighting Tuesday in northern Gaza, bringing the death toll in the ground offensive against Hamas to 48.

They were named as Cpt. Omri Yosef David, 27, from Carmiel, a deputy company commander in the Negev Brigade’s 9217 Battalion, and Cpt. Yedidya Asher Lev, 26, from Tal Menashe, a deputy company commander in the Givati Brigade’s Shaked Battalion.

Additionally, the IDF said four soldiers and officers were seriously wounded during fighting in Gaza on Tuesday.

Also Wednesday, the army said troops raided a Hamas training base in northern Gaza the previous day, locating a tunnel shaft and dozens of weapons.

Separately, the IDF said it carried out an overnight drone strike against two Hamas operatives who exited a building that housed an anti-tank missile launch position and placed “bags suspected of being explosive devices” on a road used by Israeli troops.

Ahead of the raid on Shifa, Prime Minister Benjamin Netanyahu held a lengthy phone conversation with US President Joe Biden, which the White House said focused on efforts to release the hostages.

The Biden administration on Tuesday confirmed long-held Israeli assertions that Hamas is using medical facilities for military purposes.

“We have information that Hamas and the Palestinian Islamic Jihad use some hospitals in the Gaza Strip, including al-Shifa, and tunnels underneath them to conceal and to support their military operations and to hold hostages,” White House National Security Council spokesperson John Kirby told reporters during a briefing.

“Hamas and the Palestinian Islamic Jihad members operate a command and control [center] from al-Shifa in Gaza City. They have stored weapons there and they’re prepared to respond to an Israeli military operation against that facility,” Kirby said, citing US intelligence assessments.

He clarified that the US does not support Israel striking the medical center from the air.

“Hospitals and patients must be protected,” the White House spokesperson said, noting that innocent people are sheltering inside and do not “deserve not to be caught in the crossfire.”

The scenario highlighted the challenging military operation that Israel is trying to pull off, as Hamas embeds itself within civilian populations, Kirby said.

He asserted that Hamas’s actions do not lessen Israel’s responsibility to protect civilians.

In response, Hamas lashed out at the White House, saying Kirby’s remarks gave a “green light” to Israel to commit “brutal massacres” targeting hospitals in Gaza.

“The United States bears direct responsibility for enabling Israel’s genocidal war on Gaza,” the group added.

The focus on Shifa and other hospitals, which have complained of dwindling supplies and patient deaths due to the fighting, has ratcheted up pressure on Israel to do more to protect Gazan civilians caught in the crossfire. US and European officials have called on Israel to protect the medical complex, as the IDF continues to produce evidence showing that Hamas operates within and underneath hospitals as a matter of policy.

In his Tuesday evening press conference, IDF Spokesman Rear Adm. Daniel Hagari said hospitals in the Strip risk losing their protected status under international law due to Hamas’s use of the sites for military activities.

“We are forced to operate in a focused and careful manner against Hamas’s terror infrastructure in the hospitals,” he said. “We call on the Hamas operatives who are hiding in the hospitals to surrender so as not to endanger those in the hospitals.”

Hagari also said Al-Quds Hospital in Gaza City had completed its evacuation on Tuesday. The Palestinian Red Crescent confirmed the evacuation was completed and said the wounded were transported for care in hospitals in the south of Gaza.

Several days ago, Hamas operatives fired RPGs and opened fire at troops from that hospital.

In addition to its use of Shifa Hospital, the military believes Hamas held hostages under Rantisi Hospital; the terror group has a tunnel network under the Indonesian Hospital; and opened fire at troops from Sheikh Hamad Hospital.

“Hamas uses [hospitals] as a human shield for terror. The world must know what it does in the hospitals, and we will continue to expose its crimes,” Hagari said.

The military shared on Tuesday a recording of a conversation between an IDF liaison officer and the director of the Shifa Hospital regarding the transfer of the incubators along with four breathing machines and other critical medical equipment.

On Sunday, the IDF said it had supplied 300 liters of fuel to Shifa Hospital, in coordination with its staff, but that Hamas had prevented the embattled medical center from accepting it.

War erupted after Hamas-led terrorists launched a devastating onslaught on October 7, in which they rampaged through southern communities, killing over 1,200 people, mostly civilians butchered in their homes and at a music festival, and kidnapping some 240 people. Israel then declared war with the aim of toppling the terror group’s regime in Gaza, which it has ruled since 2007.

The Hamas-run Gaza health ministry said Tuesday that 11,240 people had been killed in Gaza since the start of the war, in figures that cannot be independently verified, do not distinguish between civilians and terror operatives, and also include those killed in hundreds of failed Palestinian rocket launches.

Agencies contributed to this report.