All surgery requires a set of medical tools, typically found in the Operating Theatre, along with an operating table.
Surgery Speed and Failure
For every tool there are ghetto analogues. The percentages listed next to them show how efficient they are speed wise compared to the basic tools (on TG the percentages used to simply mean success rate until Oct 2019). For example, if it says "50%" the step takes double the time to complete. These percentages stack with the percentage point bonus or malus from using different tables or chemicals (see Beginning of any Operation).
However, the slowness is capped to 2x the original time the step would have taken. A step that takes 10 seconds would cap at 20 seconds, for example. Every second after that cap will instead add 1 percentage point into the odds of a failure. Failing may cause extra damage or other effects.
So for example:
- Say a surgery step takes 10 seconds by default, but you use a pen (25%) instead of a hemostat and do it on the floor (50%) instead of a surgery table.
- Now the surgery is slowed to 40 seconds, but since it's capped at 20 seconds it takes 20 seconds.
- Those 20 extra seconds that were removed when we capped it to 20 seconds is now your chance to fail.
- Result: The step takes 20 seconds and has a 20% chance to fail.
Beginning of any Operation
Step 1: Undress the part of the patient that needs surgery. You can do this by dragging them onto yourself, and then clicking the clothes you want to remove from them in the pop-up.
- Important: The uniform the patient is wearing usually covers both legs, arms, groin and torso. Helmets, eyewear and masks always obscure the eyes, make sure to remove them if working on the eyes.
Step 2: Place the patient onto the operating table. Do this doing a Hold CTRL and left-click a person with your hand empty. It doesn't matter if Combat Mode Enable with 4, disable with 1 or toggle with F by default. Left-clicking people with an empty hand will Harm them if on, or Help them if off. Prevents you from switching places or being pushed when colliding with people. is on or off. Repeat after a short delay to upgrade grab to aggressive (lvl 2), neck (lvl 3) and strangling (lvl 4). on the patient. Then left click the operating table to place the patient on it. You can also Ordinary right-click. It doesn't matter if Combat Mode Enable with 4, disable with 1 or toggle with F by default. Left-clicking people with an empty hand will Harm them if on, or Help them if off. Prevents you from switching places or being pushed when colliding with people. is on or not. shove a person onto the table and tell them to rest, though they might not appreciate this.
- If there is no operating table, you can use: Stasis bed (-10%), any table (-20%), any bed (-30%), ask them to lie on the floor (-50%). The speed of completing every step will be reduced.
- The stronger the alcohol, the more effective! The formula is: 0.1*(booze power/65). For example: Ethanol gives +10% surgery speed, Manly Dorf +15%, Bacchus' Blessing +46%.
- If you done step 1 wrong, it will tell you that you must remove clothing first. If you continue without fixing, you will stab your patient instead of doing surgery.
Step 4: Turn off Combat Mode Enable with 4, disable with 1 or toggle with F by default. Left-clicking people with an empty hand will Harm them if on, or Help them if off. Prevents you from switching places or being pushed when colliding with people. . Pro tip: Ordinary right-click. It doesn't matter if Combat Mode Enable with 4, disable with 1 or toggle with F by default. Left-clicking people with an empty hand will Harm them if on, or Help them if off. Prevents you from switching places or being pushed when colliding with people. is on or not. will make you fail every surgery step on purpose.
Step 6: Turn off Combat Mode Enable with 4, disable with 1 or toggle with F by default. Left-clicking people with an empty hand will Harm them if on, or Help them if off. Prevents you from switching places or being pushed when colliding with people. and then left-click. Do the surgery (see the steps below!). Afterwards congratulate the patient and kick them out. Failed steps will autorepeat.
To abort a surgery, hold a cautery in one hand and drapes in the other, and use the drapes on the patient.
Procedures requiring no research or computer
This surgery covers operations to remove/insert organs (brain, heart, appendix), cyber implants and alien embryos.
The body part to target depends on which procedure you want to do.
See below for details about each procedure.
Ordinary organs that require Organ Manipulation
These organs are present in every normal human, and can be removed or transferred through the Organ Manipulation surgery type.
The source of consciousness, and where the player actually resides. Removing the brain from a body will make it unrevivable 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 revived.
Changelings' brains are vestigial, and they can survive without them. Beheading a changeling will not prevent one from reviving.
Note: Brains can also be removed by beheading the target and using a sharp object on the head to extract the brain.
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.
They're required for sight. Removing them will, obviously, turn the patient blind. Some races' eyes can see in the dark.
Required for hearing. Removing them will make the patient deaf.
Required for processing reagents. Removing the liver will cause the patient to take heavy toxin damage. Some starting jobs give you a liver with special benefits.
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.
Required for eating and drinking.
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.
Removing it cures appendicitis and prevents it in the future too, it is not required for survival so don't go worrying about that.
Other organs that require Organ Manipulation
There are also non-natural organs which can be added to give bonuses or to harm the patient in a few cases.
These offer benefits to the patient at the cost of being very vulnerable to EMPs, with malfunctions ranging from eye-flashing to heart attacks. Cybernetic implants always require the Organ Manipulation type surgery, even for arms. Cybernetic implants can be printed by Robotics or the medbay techfab after research.
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. Cybernetic organs can be printed by Robotics or the medbay techfab after research.
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.
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.
This surgery covers operations to remove/insert external organs. External organs include lizard horns, frills, tails, snouts, moth antennae and wings, podperson hair and more. If you want to haunt someones dreams, this is the surgery for you.
Functions and mechanics associated with an external organ will be transferred aswell. Give your patient moth wings and they will be able to fly like a moth.
The body part to target depends on which external organs you want to add/remove. Tails are in the groin, while spines and wings are in the chest.
Prosthesis Organ Manipulation
Alien Organ Manipulation
Used to remove or add organs from Xenos.
This surgery is an extended organ manipulation, cutting open the chest cavity and removing a disfunctional lobe within the lungs. This restores health to the lungs, and makes them operable, if they weren't before. Be warned, however, that this surgery can only be done once per set of lungs. Can only be performed if the patient's lungs are above 60 damage, which is a tad past severe damage thresholds. Do NOT confuse this surgery with lobotomy!
This surgery is an extended organ manipulation, cutting open the chest cavity and grafting a bypass onto the patient's heart. This restores health to the heart, and makes it operable, if it was not before. Be warned, however, that this surgery can only be done once per heart, and that incising the heart and attaching the graft are not guaranteed successes. Keep bandages on hand in the event of failing the step, which will result in massive amounts of bleeding. Can only be performed if the heart has more than 60 damage (tad past severe damage threshold).
Removes damaged parts of the liver so that the liver may regenerate properly. A liver healing surgery, similar to Coronary Bypass and Lobectomy. This liver surgery only shows up as an option when liver damage is above 50 and the liver itself is not failing.
Failing the last scalpel step will deal damage to the liver.
Removes a piece of your duodenum, attaching your stomach back to your lower intestines. A stomach healing surgery, similar to Coronary Bypass, Lobectomy and Hepatectomy. This surgery will appear only if your stomach has at least 50 damage, and will help you be able to digest food again without disgust.
Failing the second scalpel step will damage the stomach further.
Sever a limb from the torso. Tails are handled under Organ Manipulation (groin).
Replace a severed limb with either a normal or a robotic limb.
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.
We can rebuild him. We have the technology.
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. You can only have one cavity implant at a time.
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!
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.
|Step 1: Surgical Drill: Drill a hole in a tooth.||(60%) (60%) (20%)|
|Step 2: Pill/Patch: Insert a pill/patch.|
This procedure cures all severe and basic traumas and reduces brain damage by a large amount. Failing step 5, however, causes hefty brain damage.
This fixes all damage done to eyes (fixing blindness), except genetic. Failing step 4 will cause 70 brain damage to the patient.
If the patient's face is damaged and unrecognizable it restores it, otherwise it change the face and identity of the patient.
Removes excess fat from the patient. Can only be selected if the patient is fat.
The target is resurrected by this surgery. It works on any non-husked corpse with a head, even if it doesn't have a heart. If the body has sustained too much damage, it'll die immediately after the revival. You can circumvent this by applying synthflesh or performing Tend Wounds beforehand.
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.
|Step 1: Scalpel: make an incision.||(65%) (45%) (75%) Any other sharp item (30%)|
|Step 2: Hemostat: extract core.||(100%)|
Removes reagents from the patient's bloodstream. Doesn't work if the patient is a husk.
Induces vomiting in a patient, which removes a large portion of ingested reagents from the stomach. Requirements:
- Patient must not be a husk.
- Patient must have reagents in the stomach from eating food.
Repair Bone Fracture
Repairs hairline fractures.
|Step 1: Scalpel: make an incision.||(65%) (45%) (75%) Any other sharp item (30%)|
|Step 2: Bonesetter/bone gel/surgical tape: repair hairline fracture.||(30%)|
Repair Compound Fracture
Repairs the most critical type of bone fracture, compound fractures.
Debride Infected Flesh
Repairs burn wounds.
|Step 1: Hemostat: excise infection.||(85%) (60%) (40%)|
|Step 2: Medical gauze/surgical tape: bandage burns.|
Repairs pierce wounds. Repeat step 2 and 3 (cycle between them) until healed.
These surgeries are available roundstart but can be upgraded to better or different versions by researching certain nodes and then syncing a connected operating computer.
The tend wounds surgeries all share the same steps. They can be upgraded by researching certain nodes, and then syncing the operating computer with research database. There are "bruises", "burn" and "Mixture" versions. By default only "bruises" and "burn" are available. The basic versions of this surgery can be performed anywhere, but the upgraded versions require an operating table with an adjacent and synced operating computer.
- Step 2 will heal at least 5 damage each time it's repeated, with an added bonus the more damaged the patient is. This the bonus healing becomes higher with higher tiers of research, ranging from (patient's damage / 75) to (patient's damage / 12.5). The bonus is much lower on dead patients.
- Without any research the heal is 5 damage plus a bonus from damage. ("bruises" and "burn" versions only).
- With Improved Wound-Tending Surgery researched and synced, it will heal 5 damage plus a higher bonus from damage ("bruises" and "burn" versions only).
- With Advanced Surgery researched and synced, it will heal 5 damage plus an even higher bonus from damage ("bruises" and "burn" versions only).
- With Advanced Surgery researched and synced, you'll be able to do the "mixture" version (tend physical wounds), which heals 3 brute and burn plus a bonus from damage, but the step takes much shorter time than the other two versions.
- With Experimental Surgery researched and synced, "tend physical wounds" will heal 3 brute and burn plus a better bonus from damage.
- With Alien Surgery researched and synced, "tend physical wounds" will heal 1 brute and burn plus a very high bonus from damage.
- Failing the hemostat step will deal some of the damage it would have healed.
- You can hold a Health Analyzer in your other hand to see your patient's remaining wounds while treating them.
If research was completed in the middle of surgery, you must restart the surgery to get the upgraded version.
These surgeries require the Advanced Surgery research node. After it is researched you must sync an operating computer (click "View Surgery Procedures" and then "Sync with research database") to unlock the procedures. Advanced surgeries can only be performed on an operating table with a connected operating computer.
Used to cure deep-rooted brain traumas. This can cause a random, permanent trauma, or if lucky, a random special trauma which gives you rare powers. Note that this can cause traumas regardless of the success of stages. Requires the "Advanced Surgery" technology.
A surgical procedure that reconstructs the damaged wings of moth people. The patient must be dosed with any amount of Synthflesh for the last step to work. Requires the "Advanced Surgery" technology.
These surgeries require the Experimental Surgery research node. After it is researched you must sync an operating computer (click "View Surgery Procedures" and then "Sync with research database") to unlock the procedures. Experimental surgeries can only be performed on an operating table with a connected operating computer, or everywhere by medical cyborgs with the surgery computer upgrade if they downloaded the surgery procedure. Borgs should be able to perform the 'Free hand' surgery steps with any tool—if not disabled modules.
Dissection is an surgery which is needed for Biological Technology tech and Advanced Biological Technology tech, it needs a dead subject. (You can steal monkey human or just human from geneticist lab)
The target becomes essentially becomes permanently pax-ed, and can no longer perform direct violent actions.
Requires the "Experimental Surgery" technology.
The circulatory system is woven into a mesh, severely reducing the amount of blood lost from wounds. Requires the "Experimental Surgery" technology. Mutually exclusive with Muscled Veins.
Vein Muscle Membrane
Adds a muscled membrane to blood vessels, allowing them to pump blood without a heart. Requires the "Experimental Surgery" technology. Mutually exclusive with Vein Muscle Membrane.
Nerves are connected to each other multiple times, greatly reducing stun times (halving them). Requires the "Experimental Surgery" technology. Mutually exclusive with Nerve Grounding.
Nerves form a safe path for electricity to traverse, making the user nigh immune to all electric shocks. Requires the "Experimental Surgery" technology. Mutually exclusive with Nerve Splicing.
Reshapes the connections between torso and limbs, making it so limbs can manually be attached if severed. However this weakens the connection, making limbs easier to detach as well. Requires the "Experimental Surgery" technology. Mutually exclusive with Ligament Reinforcement.
Adds a protective tissue and bone cage around the connections between the torso and limbs, preventing dismemberment. However, the nerve connections as a result are more easily interrupted, making it easier to disable limbs with damage. Requires the "Experimental Surgery" technology. Mutually exclusive with Ligament Hook.
The target is forced into a symbiotic relationship with a virus. It makes the virus stay at stage 1 where it's usually harmless, but still infective to others .
Note: The target must already be infected before you can initiate this surgery with the drapes. The target must be dosed with at least 5 units of Virus Food, Formaldehyde, and Spaceacillin for the "Viral Bond" step to work. This surgery will not hide the virus icon from medical huds.
Requires the "Experimental Surgery" technology.
These surgeries require the Alien Surgery research node, which requires the Alien Technology node, which can only be revealed from deconstructing certain abductor items. After it is researched you must sync an operating computer (click "View Surgery Procedures" and then "Sync with research database") to unlock the procedures. Alien surgeries can only be performed on an operating table with a connected operating computer.
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 either the brainwashing disk, acquired through the Syndicate Uplink, or researching the "Alien Surgery" technology.
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 the "Bionecrosize" step to work. Requires the "Alien Surgery" technology.