At least 274 Palestinians were killed in the Israeli air and ground raid that rescued four hostages held by Hamas, Gaza’s Health Ministry has said.

It added that around 700 other people were injured in Saturday’s operation.

The complex assault deep into central Gaza was the largest rescue operation since October 7th, when Hamas and other militants stormed across the border into Israel, killing some 1,200 people and taking around 250 hostage.

Israel launched a massive offensive in response that has so far killed more than 36,700 Palestinians, according to the ministry, which does not differentiate between civilians and combatants in its counts.

Israelis celebrated the return of Noa Argamani, 26; Almog Meir Jan, 22; Andrey Kozlov, 27; and Shlomi Ziv, 41, after Israeli forces raided two locations at once while under fire on Saturday.

Ms Argamani had been one of the most widely recognised hostages after being taken, like the three others, from a music festival. The video of her abduction showed her seated between two men on a motorcycle as she screamed “Don’t kill me”.

Her mother, Liora, has brain cancer and had released a video pleading to see her daughter. Israel’s Channel 13 said Ms Argamani was taken to the hospital where her mother is being treated.

But Mr Meir Jan’s aunt, Dina, said his father had died on Friday, hours before the rescue operation. “My brother died of grief, and he didn’t get to see Almog return,” she told Israel’s Kan public broadcaster.

Dr Itai Pessach, a medic at Sheba Hospital where the freed captives are being treated, said none have serious physical injuries but it is likely to be days before they can be discharged.

“A lot of them have lost friends and family,” he said. “Things happened in these eight months that they weren’t here. So (medical staff) have been assisting them in rebuilding the infrastructure of their life.”

In Gaza, medics described scenes of horror and chaos as those injured in the operation to free the hostages poured into nearby hospitals that were already struggling to treat the wounded from days of heavy Israeli strikes in the area.

Karin Huster of Doctors Without Borders, an international charity working in the Al-Aqsa Martyrs Hospital, said: “We had the gamut of war wounds, trauma wounds, from amputations to eviscerations to trauma, to TBIs (traumatic brain injuries), fractures, and obviously, big burns.

“Kids completely grey or white from the shock, burnt, screaming for their parents. Many of them are not screaming because they are in shock.”

The Israeli military said it had attacked “threats to our forces in the area”, and that a special forces officer was killed in the rescue operation.

Military spokesman Rear Admiral Daniel Hagari said the hostages were being held in two apartments, about 200 metres from each other, in the heart of the Nuseirat refugee camp. He said the forces had trained repeatedly on a model of the apartment buildings.

Mr Hagari said the forces moved in simultaneously in broad daylight on both apartments, believing this ensured the best element of surprise. But he said the rescuers came under heavy fire as they moved out, including from gunmen firing rocket-propelled grenades from within the neighbourhood.

He said the military responded with heavy force, including from aircraft, to extract the rescuers and freed hostages.

Israeli foreign minister Israel Katz lashed out at critics of the operation in a post on X, saying “only Israel’s enemies complained about the casualties of Hamas terrorists and their accomplices”.

Of the 250 hostages abducted on October 7th, about half were released in a week-long ceasefire in November. About 120 hostages remain, with 43 pronounced dead. Survivors include about 15 women, two children under five and two men in their 80s.

Saturday’s operation brought the total number of rescued hostages to seven, including one who was freed shortly after the October attack. Israeli troops have recovered the bodies of at least 16 others, according to the government.

The latest rescue lifted some spirits in Israel as divisions deepen over the best way to bring hostages home. Many Israelis urge prime minister Benjamin Netanyahu to embrace a ceasefire deal US president Joe Biden announced last month, but far-right allies threaten to collapse his government if he does.

Mr Netanyahu, whose support has fallen, rushed to greet the freed hostages on Saturday and his office released a stream of photos and videos of him meeting the families.

But thousands of Israelis again gathered on Saturday evening for the latest anti-government demonstration and calls for a ceasefire agreement.