All surgery requires a set of medical tools, typically found in the Operating Theatre, along with an operating table.
Surgical Tools
Information about most tools used in surgery can be found here.
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: Place the patient onto the operating table. Do this by selecting grab intent. Then click the patient twice in a row until you have an aggressive grab. Then left click the operating table to place the patient on it. Switch back to help intent or your surgery will fail.
- 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.
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%) for faster surgery speed.
- 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%.
Step 1.2: (Optional) Use a tank of anesthetic and a breath mask to make your patient sleep. This has no surgical benefits however.
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. 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
Organ Manipulation
This surgery covers operations to remove/insert organs (brain, heart, appendix), lizard/cat tails, 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.
Brain
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.
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.
Eyes
They're required for sight. Removing them will, obviously, turn the patient blind. Some races' eyes can see in the dark.
Ears
Required for hearing. Removing them will make the patient deaf.
Liver
Required for processing reagents. Removing the liver will cause the patient to take heavy toxin damage.
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.
Stomach
Required for digesting food.
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.
Appendix
Removing it cures appendicitis and prevents it in the future, too.
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.
Cybernetic Implants
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
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.
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.
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.
Prosthesis Organ Manipulation
Augmented limbs have special surgery steps for Organ Manipulation that are completed with mechanical tools. Unlike all other procedures, this can be performed on yourself with self-surgery.
Target: Head, chest, groin, arms
Alien Organ Manipulation
Used to remove or add organs from Xenos.
Lobectomy
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!
Coronary Bypass
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).
Hepatectomy
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.
Gastrectomy
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.
Amputation
Sever a limb from the torso. Tails are handled under Organ Manipulation (groin).
Prosthetic Replacement
Replace a severed limb with either a normal or a robotic 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.
We can rebuild him. We have the technology.
Target: Head, chest, legs or arms
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. You can only have one cavity implant at a time.
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!
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.
Procedure | Ghetto Analogues |
Step 1: Surgical Drill: Drill a hole in a tooth. | (60%) (60%) (20%) |
Step 2: Pill/Patch: Insert a pill/patch. |
Brain Surgery
This procedure cures all severe and basic traumas and reduces brain damage by a large amount. Failing step 5, however, causes hefty brain damage.
Eye Surgery
This fixes all damage done to eyes (fixing blindness), except genetic. Failing step 4 will cause 70 brain damage to the patient.
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: 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.
Lipoplasty
Removes excess fat from the patient. Can only be selected if the patient is fat.
Revival
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.
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%) |
Stomach Pump
Induces vomiting in a dead patient which removes a large portion of reagents from the body. Requirements:
- Patient must be dead.
- Patient must not be a husk.
- Patient must have nutrients from eating food.
Upgradable Surgery
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.
Tend Wounds
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 (or Stasis bed) with an adjacent and synced operating computer.
The target is healed by this surgery, without any chemicals being involved. Useful for healing dead bodies for revival. This works on patients with clothes on, but it's only 55% as effective.
- 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.
If research was completed in the middle of surgery, you must restart the surgery to get the upgraded version.
Advanced Surgery
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 (or Stasis bed) with a connected operating computer.
Lobotomy
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. Requires the "Advanced Surgery" technology.
Wing Reconstruction
An experimental surgical procedure that reconstructs the damaged wings of moth people. The patient must be dosed with at any amount of Synthflesh for the last step to work. Requires the "Advanced Surgery" technology.
Experimental Surgery
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 (or Stasis bed) with a connected operating computer.
Pacification
The target becomes essentially becomes permanently pax-ed, and can no longer perform direct violent actions.
Requires the "Experimental Surgery" technology.
Vein Threading
The circulatory system is woven into a mesh, severely reducing the amount of blood lost from wounds. Requires the "Experimental Surgery" technology.
Muscled Veins
Adds a muscled membrane to blood vessels, allowing them to pump blood without a heart. Requires the "Experimental Surgery" technology.
Nerve Splicing
Nerves are connected to each other multiple times, greatly reducing stun times. This caps stun times to 4 seconds. Requires the "Experimental Surgery" technology.
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.
Ligament Hook
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.
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.
Cortex Imprint
Performing this surgery makes the brain more resilient from basic brain traumas obtained through damage to the brain. You can only choose to either do this OR Cortex Folding, never both.
Cortex Folding
Performing this surgery gives a higher chance of getting a Special brain trauma through Lobotomy. You can only perform either this one OR Cortex Imprint, never both.
Viral Bonding
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.
Alien Surgery
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 (or Stasis bed) with a connected operating computer.
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 either the brainwashing disk, acquired through the Syndicate Uplink, or researching the "Alien Surgery" technology.
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 the "Bionecrosize" step to work. Requires the "Alien Surgery" technology.