Surgery

All surgery requires the set of medical tools in the Operating Theatre, along with a table (a surgical table gives no negative results). For the most part, only medical doctors and the Chief Medical Officer can perform advanced surgery.

Surgical Tools

Information about every tool used in surgery can be found here.

For every tools there are ghetto analogues. Using them lowers chances of performing a surgical step correctly, wounding your patient. Hover your cursor over the item's picture to see its name. Next to the items are the success rates.

Beginning of any Operation

Step 1: Place the patient onto the operating table.

• If there is no operating table, you can use: any table (-20%), any bed (-30%), ask them to lie on the floor (-50%). Chances of successfully completing every step will be reduced.

Step 1.1 (Optional) Splash on, spray or apply a patch with Miner's Salve (+10%), Sterilizine (+20%), alcoholic drinks (up to +46%), or Honey (+60%) to improve your success chance.

• The stronger the alcohol, the more effective! The formula is: 0.1*(booze power/65). For example: Ethanol gives +10% success chance, Manly Dorf +15%, Bacchus' Blessing +46%.

Step 1.2: (Optional) Use a tank of anesthetic and a breath mask to make your patient sleep.

Step 2: Place drapes or bedsheet over the part of body you are operating.

Step 3: Switch to help intent. Pro tip: Disarm intent will fail every surgery step.

Step 4: Aim at the appropriate body part (important!).

Step 5: Do the surgery (see the steps below!). Afterwards congratulate the patient and kick them out.

To interrupt a surgery, hold a cautery in one hand and drapes in the other, and use the drapes on the patient.

Basic Organs

These organs are present in every normal human, and can be removed or transferred through Organ Manipulation.

Brain

The source of consciousness, and where the player actually resides. Removing the brain from a body will make it unclonable through normal means. The brain can also be inserted into an MMI to allow it to speak, and to prepare it to be inserted into a Cyborg or an AI. Or it can be transferred into another body, which can then be cloned or defibrillated with the new host.

Changelings' brains are vestigial, and they can survive without them. Beheading a changeling will not prevent one from reviving.

Target: Head

Note: Brains can also be removed by beheading the target and using a sharp object on the head to extract the brain.

Note: There's also a non-surgery method to put a brain back in:

Step 1: Place the patient onto the operating table.

Step 2: Cram their brain back into their skull.

Step 3: Usually, you take the body to be cloned.

Heart

Required for basic survival, removing it will cause a heart attack, dealing huge amounts of oxygen damage until a new, beating, heart is inserted, or death. This can be delayed with epinephrine, if you need more time.

On their own, hearts only beat for a short time when removed from a living body. To get a heart beating again, click on it while it's in your hand.

Heart attacks can also be induced by Initropidril, and a heart attack may continue if you insert a still heart in a patient. In either case, to restore the heart to normal functionality, the patient needs to either be defibrillated or receive an electric shock.

Target: Chest

Eyes

They're required for sight; removing them will, obviously, turn the patient blind. Some races' eyes can see in the dark.

Target: Eyes

Lungs

Required for breathing. Removing the lungs will cause the patient to suffocate, regardless of air or internals. Some species have mutant lungs that don't need air: transplanting them onto an breathing race will transfer this property.

Target: Chest

Tongue

Affects speech. Lacking a tongue will make speech very hard to comprehend, while mutant tongues such as lizards' or flypeoples' will give the patient the race's speech quirks. Abductors' tongues carry over their telepathy, but they prevent normal speech.

Target: Mouth

Appendix

Removing it cures appendicitis and prevents it in the future, too.

Target: Groin

Other Organs

There are also non-natural organs which can be added to give bonuses or to harm the patient in a few cases.

Cybernetic Implants

Cybernetic implants made in Research and Development or Robotics. These offer benefits to the patient at the cost of being very vulnerable to EMPs, with malfunctions ranging from eye-flashing to heart attacks.

Target: Chest/Head/Eyes/Arms

Cybernetic Organs

Cybernetic organs replace organs entirely; you need to remove the corresponding organ first to make room for the cybernetic organ. They are vulnerable to EMPs.

Target: Chest/Eyes

Xenomorph Embryo

An alien larva growing inside the patient. If not removed quickly enough, it will gib the patient and try to escape, growing into a dangerous Xenomorph.

Target: Chest

Romerol Tumor

A latent infection in the patient's head, caused by Romerol. If the patient dies while affected by Romerol, he will eventually rise as an aggressive Zombie. This will repeat as long as the infection lasts; removing it surgically, cutting the head off, or gibbing the corpse will prevent resurrection.

Romerol is infective, and anyone hit by a zombie while unprotected will also acquire a Romerol Tumor.

Target: Head

Surgical Procedures

Limb Manipulation

Removing limbs, reattaching them, augmenting them.

Robotic surgery steps

Augmented limbs have simplified surgery steps for organ manipulation/implant removal that are completed with mechanical tools:

Target: Head, chest, legs or arms

Procedure	Ghetto Analogues
Step 1: Screwdriver: unscrew the shell.	(75%) (50%) Any other sharp item (30%)
Step 2: Hands: open the hatch.
Step 3: Wrench: unwrench the bolts.	(10%)
Step 4: (Multitool: prepare electronics.)	(10%)
Step 5: Hemostat: manipulate organs/remove implant.	(65%)
Step 6: Wrench: wrench the bolts.	(10%)
Step 7: Screwdriver: screw the shell.	(75%) (50%) Any other sharp item (30%)

Amputation

Sever a limb from the torso. Tails are handled under organ manipulation (groin).

Target: Head, legs, or arms

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 3: Retractor: retract the skin.	(45%) (35%)
Step 4: Circular Saw: cut through the bone.	(65%) (50%) (50%) (35%) (25%) (75%)
Step 5: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 6: Scalpel or Circular Saw: sever the limb.	(80%) (50%) (40%) (25%) (80%)

Prosthetic Replacement

Replace a severed limb with either a normal or a robotic limb.

Target: Head, legs or arms

Procedure	Ghetto Analogues
Step 0: Acquire the required limb.
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 3: Retractor: retract the skin.	(45%) (35%)
Step 4: Limb/Cyborg limb: replace the limb.
Step 4(Alternative): Chainsaw/Synthetic Arm Blade: replace the limb with the chosen weapon.

Limb Augmentation

Replace a limb with a robot part. The head, torso, arms, and legs can all be augmented. Augmenting torso makes you immune to appendicitis and xeno larva.
Robot limbs are tougher. They need welding to "heal" brute damage and wires for burn damage, and cannot be otherwise healed. EMP pulses will hurt augmented humans.

Cyborg head

Cyborg torso

Cyborg arm

We can rebuild him. We have the technology.

Target: Head, chest, legs or arms

Procedure	Ghetto Analogues
Step 0: Create the cyborg limb(s) using an Exosuit Fabricator.
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 3: Retractor: retract the skin.	(45%) (35%)
Step 4: Scalpel: sever the muscles.	(55%)
Step 5: Circular Saw: cut through the bone.	(65%) (50%) (50%) (35%) (25%) (75%)
Step 7: Cyborg limb: augment the limb.

Organs and implants

Removing and shoving in extra organs or implants.

Organ Manipulation

This surgery covers operations to remove/insert organs (brain, heart, appendix), lizard/cat tails, cyber implants and alien embryos.
The body part target depends on which procedure you want to do.
See below for details about each procedure.

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Retractor: retract the skin.	(45%) (35%)
Step 3 (Head/Chest only): Circular Saw: saw through bones.	(65%) (50%) (50%) (35%) (25%) (75%)
Step 4: Hemostat: clamp the bleeders.	(60%) (35%) (15%)
Step 5: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 6 Remove: Hemostat: remove something.	(55%)
Step 6 Insert: Hands: insert something.
Step 7: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

(Alien Organ Manipulation variant for xenos)

Procedure	Ghetto Analogues
Step 1: Circular Saw: saw through the bone.	(65%) (50%) (50%) (35%) (25%) (75%)
Step 2: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 3: Retractor: retract the skin.	(45%) (35%)
Step 4: Circular Saw: saw through the bone.	(65%) (50%) (50%) (35%) (25%) (75%)
Step 5 Remove: Hemostat: remove something.	(55%)
Step 5 Insert: Hands: Insert something.
Step 6: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Cavity Implant

Implant/Remove an object in the chest. Tiny and small items can be implanted. Implanting a flashlight allows the patient to toggle it on or off. Implanting grenades is also often done.

Flashlight is commonly implanted

Target: Chest

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 3: Retractor: retract the skin.	(45%) (35%)
Step 4: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 5: Place an item in the cavity / Use your hands to check for items in the cavity.
Step 6: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Implant Removal

Extracts mindshield, tracking, chemical, traitor, explosive implants and such. If you don't have an empty implant case in your other hand, the implant will be ruined on extraction!

Removes this

Target: Chest

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 3: Retractor: retract the skin.	(45%) (35%)
Step 4: Hemostat and Empty Implant Case: extract the implant.	(65%)
Step 5: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Dental Implant

This allows you to insert pills/patches into a tooth cavity, allowing you to pop it any time to ingest it. This works for both stimulants and suicide pills.

Target: Mouth

Procedure	Ghetto Analogues
Step 1: Surgical Drill: Drill a hole in a tooth.	(60%) (60%) (20%)
Step 2: Pill/Patch: Insert a pill/patch.

Medical surgery

Brain Surgery

This procedure cures all traumas and reduces brain damage by a large amount. Failing step 5, however, causes hefty brain damage.

Target: Head

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Retractor: retract the skin.	(45%) (35%)
Step 3: Circular Saw: cut through the bone.	(65%) (50%) (50%) (35%) (25%) (75%)
Step 4: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 5: Hemostat: perform brain surgery. (85%)	(35%) (15%)
Step 6: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Eye Surgery

This fixes all damage done to eyes (fixing blindness), except genetic. Failing step 4 will cause 70 brain damage to the patient.

Target: Eyes

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Retractor: retract the skin.	(45%) (35%)
Step 3: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 4: Hemostat: fix the patient's eyes.	(45%) (25%)
Step 5: Cautery: mend the incision.	(90%) (70%) (45%) (20%)

Removal of Embedded Objects

Extracts objects stuck in the body such as throwing stars or spears.

Target: Head, chest, legs, or arms

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 3: Retractor: retract the skin.	(45%) (35%)
Step 4: Remove: Hands: Remove object.

Plastic Surgery

If the patient's face is damaged and unrecognizable it restores it, otherwise it change the face and identity of the patient.

Target: Head

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Retractor: retract the skin.	(45%) (35%)
Step 3: Scalpel: alter the patient's appearance.	(50%) (35%)
Step 4: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Lipoplasty

Removes excess fat from the patient.

You get this

Target: Chest

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 3: Circular Saw: cut up the fat.	(35%) (25%)
Step 4: Retractor: remove the fat.	(45%) (35%)
Step 5: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Slime Core Removal

Remove core from slime. Step 2 must be repeated for every core if slime has several. Mostly obsolete with existence of slime grinder, but still possible.

A slime

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Hemostat: extract core.	(60%) (35%) (15%)

Advanced Surgery

These surgeries require research. After they are researched you must refresh an operating computer to unlock them. Advanced surgeries can only be performed on operating tables with a connected operating computer.

Bioware

Nerve Grounding

Nerves form a safe path for electricity to traverse, making the user nigh immune to all electric shocks. Requires the nerve grounding disk, acquired through researching the "Experimental Surgery" technology. On the other hand, you could just wear insulated gloves.

Target: Chest

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Retractor: retract the skin.	(45%) (35%)
Step 3: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 4: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 5: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 6: Hands: ground nerves
Step 7: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Nerve Splicing

Nerves are connected to each other multiple times, greatly reducing stun times. Requires the nerve splicing disk, acquired through researching the "Experimental Surgery" technology.

Target: Chest

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Retractor: retract the skin.	(45%) (35%)
Step 3: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 4: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 5: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 6: Hands: splice nerves
Step 7: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Vein Threading

The circulatory system is woven into a mesh, severely reducing the amount of blood lost from wounds. Requires the vein threading disk, acquired through researching the "Experimental Surgery" technology.

Target: Chest

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Retractor: retract the skin.	(45%) (35%)
Step 3: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 4: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 5: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 6: Hands: thread the veins
Step 7: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Other

Brainwashing

The target of this surgery, when successful, is bound to a primary goal you assign to him/her. He/she must follow these objectives, regardless of allegiance.
This can be cured through brain surgery or with a mindshield implant.
Requires the brainwashing disk, acquired through the Syndicate Uplink or by researching the "Alien Surgery" technology.

Target: Head

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Retractor: retract the skin.	(45%) (35%)
Step 3: Circular Saw: cut through the bone.	(65%) (50%) (50%) (35%) (25%) (75%)
Step 4: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 5: (85%) Brainwash: perform the brainwashing procedure. Failing will grant brain damage.	(50%) (35%) (15%)
Step 6: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Lobotomy

Used to cure the most serious of brain ailments. This will cause a random, non-curable trauma!
Requires the lobotomy disk, acquired by researching the "Advanced Surgery" technology.

Target: Head

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Retractor: retract the skin.	(45%) (35%)
Step 3: Circular Saw: cut through the bone.	(65%) (50%) (50%) (35%) (25%) (75%)
Step 4: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 5: Lobotomize (85%): perform the lobotomy procedure.	(35%) (25%) (55%) Any other sharp item (20%)
Step 6: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Necrotic Revival

Revives a corpse into an infectious zombie which will probably munch your face off. Useful for forcing a shuttle call.
Note: The target must be dosed with at least 5 units of Zombie Powder or Rezadone for this surgery to work.
Requires the necrotic revival disk, acquired by researching the "Alien Surgery" technology.

Target: Head

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Retractor: retract the skin.	(45%) (35%)
Step 3: Circular Saw: cut through the bone.	(65%) (50%) (50%) (35%) (25%) (75%)
Step 4: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 5: Bionecrosize: perform the revival procedure.	(35%) (15%)
Step 6: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Pacification

The target becomes essentially becomes permanently pax-ed, and can no longer perform direct violent actions.
Requires the pacification disk, acquired by researching the "Experimental Surgery" technology.

Target: Head

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Retractor: retract the skin.	(45%) (35%)
Step 3: Circular Saw: cut through the bone.	(65%) (50%) (50%) (35%) (25%) (75%)
Step 4: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 5: Pacify: rewire the target's brain.	(35%) (15%)
Step 6: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Reconstruction

The target is healed by this surgery, without any chemicals being involved! Useful when healing dead bodies.
Requires the reconstruction disk, acquired by researching the "Advanced Surgery" technology.

Target: Chest

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 3: Retractor: retract the skin.	(45%) (35%)
Step 4: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 5: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 6: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 7: Retractor: retract the skin.	(45%) (35%)
Step 8: Reconstruct: repair damage to the target (Repeatable).	(35%) (15%)
Step 9: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Revival

The target is resurrected by this surgery. Unlike normal defibrillation, it works on any non-husked corpse, regardless of how much damage the body has sustained or how long the target has been dead.
If the body has sustained too much damage, it'll die immediately after the revival (you can circumvent this by applying Synthflesh beforehand).
Requires the revival disk, acquired by researching the "Experimental Surgery" technology.

Target: Head

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Retractor: retract the skin.	(45%) (35%)
Step 3: Circular Saw: cut through the bone.	(65%) (50%) (50%) (35%) (25%) (75%)
Step 4: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 5: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 6: Revive: revive the target.	(75%) (60%)
Step 7: Cautery: seal the wound.	(90%) (70%) (45%) (20%)

Viral Bonding

The target is forced into a symbiotic relationship with a virus. It turns the virus harmless to the carrier, but still infective to others.
Note: The target must be dosed with at least 5 units of Virus Food, Formaldehyde, and Spaceacillin for this surgery to work.
Requires the viral bonding disk, acquired by researching the "Experimental Surgery" technology.

Target: Chest

Procedure	Ghetto Analogues
Step 1: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 2: Retractor: retract the skin.	(45%) (35%)
Step 3: Hemostat: clamp bleeders.	(60%) (35%) (15%)
Step 4: Scalpel: make an incision.	(65%) (45%) (75%) Any other sharp item (30%)
Step 5: Viral Bond: force a symbiotic relationship.	(50%) (35%) (30%)
Step 6: Cautery: seal the wound.	(90%) (70%) (45%) (20%)