Trauma Center: Under the Knife

Trauma Center: Under the Knife is a surgical game for the Nintendo DS. In the game, you play as Derek Stiles, a doctor whom has just completed residency. The story will play itself out, but you will need to complete the operations in order for the story to advance. Be warned though, this is one of the hardest games you will play in your life. If you haven't bought this game yet, be sure to reserve an extra DS. People with short tempers will surely be chucking their DS at a wall.

Surgical tools
These are the surgical tools you will be using to perform surgery, in no particular order. To the left or right of each surgical tool in-game, there will be a bar showing how much of this tool you have left. As you use a tool, this bar will go down. It will automatically regenerate, but if you use all of it up, you will not be able to use it anymore until it is replenished.

Scalpel
This is by far one of the most used surgical tools. It is used for making the incision, removing tumors, and anything else involving cutting.

Ultrasound
This tool is used mainly for finding tumors and objects that are beneath the surface of organs. Simply tap on the touch screen to use it.

Magnifiers
This will take the place of the ultrasound in some operations. To use, select the icon and draw a C over the area that needs to be magnified.

Needle
The needle is used for suturing large cuts and for keeping things together. To use, drag in a zig-zag path along the wound. If you did it correctly, the wound should disapear and a success message will appear.

Laser
The laser is used to burn away parasites and small wounds. Applying it for too long can cause small wounds that will cause excessive bleeding warranting the use of the drain and antibiotic gel.

Advanced Laser Prototype
This is a laser developed by Victor for treatment of Pempti. It has a wider beam and is needed to operate against Pempti. It is also faster at causing wounds on the body so be careful. It is automatically put in place of the laser when you are operating on Pempti.

Antibiotic gel
This is dubbed as a miracle gel since it seems it can do anything. It is usually used for very small cuts and sterilizing incisions. One of it's secret functions is it's ability to remover blood from normal cuts and restore vitals. If you drag the gel along a cut, it will remove the blood from it, giving you a better view of it, and as it removes blood, it will restore vitals!

Drain
The drains only real purpose, is to remove blood from pooled areas. Tap your stylus in the pool of blood, and then drag it up along the drain line. repeat if neccesary.

Forceps
Most people at the begining will call these tweezers but you will eventually call them forceps. Forceps are used in removing foriegn bodies mostly. When you use them, a pan will appear. After you have removed it, drag it over to the pan and let go.

Hands
The hands are mostly noted for its companion, the Healing Touch. The hands are used to speed up the process of binding the synthetic membrane to the body and for cardiac arrest.

Healing Touch
This ability will become usable manually after "Striving for Asclepius" At other times, it will automatically kick in during the operation. In this mode, the vitals will drop slower, GUILT will operate slower or even stop alltogether, and the operation wil change into a monochrome scale.

Syringes
You will find yourself tapping the syringes quite a lot when you get further into the game because of their useful function. First, In all operations that you can use the syringe, you will have the stabilizer. When injected, it raises the vitals. Then, there are medications. These are operation specific. To use them, tap your stylus on the medication you want and drag up. Then tap anywhere on the operation and hold it there to inject.

Bandages
Bandages are only used for one purpose. You drag it across the incision line at the end of the operation to finish the operation.

Operations
Difficulty rating

1:Easy

2:Slightly difficult

3:Difficult

4:Very hard

5:Insane

Standard procedure
Difficulty rating 1

First, you will need to select the needle icon. Once you have selected it, follows along the cut in a zig-zag pattern. If you can't do anything, tap the CALL button on the upper-right corner of the screen. Then repeat. Now select the forceps and put your stylus down on the piece of glass. Now slowly move your stylus away from the blood and a pan will appear. Drag the peice of glass onto the tray and drop it. Now repeat. Select the antibiotic gel and spread it over the smaller wounds. Now, a guideline will appear. Spread antibiotic gel over it and then use the scalpel to cut swiftly along the line. The arm will open up, and there will be 3 shards of glass. Remove them and heal the wound with antibiotic gel.Then, suture the incision and disinfect it with antibiotic gel. Now drag a bandage along the line and the operation should be finished.

Standard procedure 2
Difficulty rating 1

Use the antibiotic gel to disinfect the guideline, and then cut along it with the scalpel. You will see the stomach. It will be inflamed.Select the syringe, and select the anti-inflammatory. In ject it by putting you stylus on the swollen marks. Select the ultrasound, and tap around the lower left area of the stomach Once you tap on the tumor, a shadow should appear. Use the scalpel to cut across it and it will open up. Take the drain, tap the tumor and drag up along the tube until the cytoplasm is removed. Then, a guideline around the tumor will appear. Simply cut it, and use the forceps to put it into the tray. Use the forceps again to drag the synthetic membrane on to the wound. Now spread antibiotic gel over it until an ok sign shows up. Then use the hands to meld it by rubbing it in a circular motion. Then, suture the incision and disinfect it with antibiotic gel. Finally, drag the bandage across it.

A Farewell
Difficulty rating 2

First, disinfect and cut the guideline. You will zoom into the pancreas. Select the syringe and take some of the blue anti-inflammatory. Inject it into the 2 white spots to remove the swelling. There are 3 tumors. 2 in the left area and one in the lower right area. Watch the vitals in the upper right corner, if it gets to below 30, use the syringe to iject stabilizer. Use ultrasound to locate them, and cut, drain, excise, and remove for each one. Then, use the forceps to get the membrane on the wounds, then use antibiotic and the hands on each of them. Suture the incision, disinfect, and bandage.

Singing the blues
Difficulty rating 2

First, do the usual disinfect and cut, and you will zoom into the operation. There will be an area with a pool of blood. Select the magnifier (in the same slot as ultrasound). Do NOT draw a circle around the problem area. The game is very picky about it's magnifying symbols and it doesn't recognize circles well. Instead, Draw a C With your stylus. Once you have zoomed in, take the drain and drain the blood. Select the laser and quickly run it over a group of polyps. Quickly switch to anitbiotic gel and spread it over the bleeding spots. If blood clogs the view again, drain it and gel the wounds. Repeat until all the polyps in the area are gone, and zoom out with yet another backward C Repeat this for all other polyp infected areas and then suture the incision, disinfect, and bandage.

A real doctor
Difficulty rating 2

Disinfect the guideline and cut it. You will zoom into the intestines. Select the anti-inflammatory and inject it into the swelling areas. Use the ultrasound to locate the tumors and then cut, drain, excise, and remove the tumors. Repeat for the other tumors. Take the ultrasound and tap around the screen when Angie asks you to check for any other tumors. Suture the incision, disinfect it, and bandage.

Life or death
Difficulty rating 3

Though the title implies otherwise, this is actually not a hard operation. It is just fast paced and you will need to work swiftly. Be careful though, The max vital is 30 and he has multiple wounds which bring it down. If the vitals round 15, inject stabilizer. First, apply antibiotic gel on the blue bar until it turns green. Select the hands and keep it on the green bar to revive him. His vitals will rise to 30. Suture the large wounds, remove the glass shards, and use antibiotic gel for the smaller wounds. Disinfect the guideline and cut it. There will be multiple glass shards in the pericardium. Use the forceps to take them out. Bring out only 1 or 2 shards before switching to the gel since as the wounds are in the heart, they will bleed rapidly and bring down vitals.Once, again, inject stablilizer if the vitals round 15. Repeat this process until all the glass is removed. A large shard of glass will emerge. Carefully take it out with the forceps and place it in the tray. Suture the wound. The myocardium will split open and you will go into the Healing touch. The speed that vitals drop will slow down and the screen will turn into a grey scale image. Quickly suture the wound before he dies. Suture the incision, disinfect it, and bandage.

Dormant Ability
Difficulty rating 2

First, disinfect the guideline and incise. Use the magnifier to zoom in. There will be multiple light grey brown spots in the red vessels. Use the ultrasound on them, then pinch them with the forceps. Cut the area with the scalpel and drain to remove the thrombi. Use the antibiotic gel to heal the wound and repeat for all the other thrombi. The bloodflow will change speeding up the flow of thrombi. Continue removing them using the same process. You will automatically go into the healing touch mode. Once all thrombi are removed, suture the incision, disinfect, and bandage.

Striving for Asclepius
Difficulty rating 1

Select the hand icon and then tap on it again for the healing touch. Draw a star along the guideline. Repeat this until the operation is finished. After this operation, you will be able to use the healing touch in an operation by selecting the hand and tapping it again. Then draw a star.

Awakening
Difficulty rating 5

This is a very difficult operation and do not get mad if you can't get through it with your first few tries. This will be one of the first very difficult operations such as GUILT. Disinfect the guideline and cut it. There will be a bulging artery. Zoom into it. Inject it with the sedative until a guideline appears around it. Cut it, remove it with the forceps, and drain the area. Use the forceps again to drag the artery pieces together and suture it together. Zoom out and more will appear. Zoom in so that you can see all the aneurisms and treat all of them. Repeat. Once there are 5 or 6 of them, use the healing touch. Zoom in so that you can see and treat all of the aneurisms at one time. For each aneurism, just sedate it down to size and cut it. Don't bother with removing it with forceps and reataching the area, it will take too much time that could be used bringing up the vitals and sedating all of the other aneurisms. That will stop it from growing to maximum size. If it reaches it's maximum size, it will explode dropping the vitals by approximately 40 instantly! Once all of the aneurisms have been cut open, remove them, drain the blood, bring the artery together, and suture. Do this for all of them. Now you probably don't have much time left. Suture the incision, disinfect and bandage. Now give yourself a pat on the back.

Just Let Me Die
Difficulty rating 2

Disinfect the guideline and cut it, as usual. First, you will want to take care of the smaller wounds. Suture them all, keeping an eye on the vitals. Then, raise her vitals to the max and select the drain. Drain the blood from the large wound, select the forceps, and pinch one side of the wound. Drag it over to the other side until a "Ok" sign appears then suture the wound. Do this to the other 2 wounds. Then suture, disinfect, and bandage.

Please Let Me Live
Difficulty rating 3

Disinfect the guideline and cut it. The layout will be similar to the last operation. Follow the guide for Just Let Me Die until a cut appears. Use the ultrasound to find the parasite. It will be a black shadow and resemble a manta ray. Use the scalpel to cut it out. Now, use the laser to burn it. There is no need to treat the wounds now. Just keep the vitals up and you will be fine. You will need to burn it 2 times. Then, more cuts will appear. Repeat the process. Then, treat all the wounds once you are sure there are no more parasites. Now, as if the operation wasn't exciting enough, 3 giant cuts in the shape of a * will appear. Use the ultrasound once again, to find the parasite. It is much larger than its counterparts, but is harder to remove. Each time you cut it out and burn it with the laser, it will burrow back into the organ and you will need to find it with ultrasound and cut it out again. Once the large parasite is dead, treat all the wounds, suture, disinfect, bandage.

For Everyone's Sake
Difficulty rating 2

Disinfect and cut the incision line. There will be an incision line on the heart. Disinfect and cut that too. About now, the patient will undergo cardiac arrest. Angie will defibrilate her, and a blue bar will appear similar to the one in Life or Death. Apply antibiotic gel, and use the hands to massage the heart. This will probably happen again further in the operation, and will use the same treatment. Now, drain the blood from the incision. You will need to cut along the three guidelines to excise the valve. Remove it with the forceps, and place the artificial valve in its place. Suture it in, then suture the heart incision. Suture the incision, disinfect and bandage.

GUILT
Difficulty rating 3

Disinfect the guideline and cut it. Treat all the wounds. The large wounds will need to be drained and have their edges pulled together before they can be sutured. Use the ultrasound to find the kyriaki. It will be a black shadow and resemble a manta ray. Use the scalpel to cut it out. Now, use the laser to burn it. There is no need to treat the wounds now. Just keep the vitals up and you will be fine. You will need to burn it 2 times. There will be more than one. Once you have killed all of the kyriaki in the first round, more cuts will appear along with some more kyriaki under the organ. Once you are sure there are no more kyriaki, treat the wounds and bring up the vitals. When all of the wounds and kyriaki are gone, the asteric cut will appear signifying the large kyriaki is here. Use the ultrasound once again, to find the parasite. It is much larger than its counterparts, and is also harder to remove. Each time you cut it out and burn it with the laser, it will burrow back into the organ and you will need to find it with ultrasound again. Once the large parasite is dead, treat all the wounds, suture, disinfect, and finally, bandage.

Something Precious
Difficulty rating 3

Disinfect the first guideline and cut the it. You will see the stomach with black and white tumors scattered around. Burn them with the laser. The larger tumors will create smaller tumors around them in a circle so those should be your first priority in lasering. Once all the tumors are removed, you will see a red and a blue tumor (Deftera) They will move around and occasionaly create large tumors. When they get close to each other, they will mix together and stall there. Use the drain quickly to remove their cytoplasm. They will pull away from each other and continue to move around and create tumors. It should take three succesful drainings to deplete all of it's cytoplasm. When that happens, it will be grey by now, the tumor will shrink and grow. After that, It will create tumors around it extremely fast and an incision line will appear around it. Excise it quickly to stop it from creating tumors. Then place the synthetic membrane on the wound, disinfect it, and then meld it in with your hands. Suture the guideline, disinfect it and bandage. You're not finished yet. The second guideline will appear. Disinfect and cut it. Now, you will be presented with essentialy the same operation. The only difference is that there are two pairs of deftera. When two of the same color deftera collide, it will drop the vitals and create two large tumors. Treat the lungs the same way as before.

An Explosive Patient
Difficulty rating 2

Surprise! It's a BOMB! It will blow up if you make a mistake or let a trigger reach it's breaking point. Now, select the magnifier. Magnify the water tanks. If all the water from the left tank goes into the right tank, it will blow up. Take the drain and suck the water out of the right tank, then put it back into the left tank. Now we move onto the dynamite. The dynamite has three ways of exploding.

1: The water level reaches max and it trigger the igniters and thus, explodes.

2: The electronic igniter reaches max temperature level and ignites it so it explodes.

3: A microchip that connects to the dynamite is lasered and cause the dynamite to explode.

Let's get rid of problem one now. Look at the yellow cap on the edge of each stick of dynamite. Pull it straight out of the dynamite with the forceps. After you have taken out two, the electronic igniters will activate. When the temperature bar on them reaches the top, it will cause the dynamite to explode. Quickly pull them all out of the dynamite, and the water trigger will become obsolete. Cool down all of the electronic igniters with the antibiotic gel and zoom out. Look at the wires that connect to the electronic igniters. They all connect to the motherboard above it. Trace the wires from the igniters to where they connect to the mother board above. Once you find where a wire connects to from the mother board to the electronic igniters, find the micro chip it connects to and laser it. Do this for all the other electronic igniters. Once you have lasered all the right micro chips, the clock will flash erratically. Now, you have 15 seconds before the bomb blows up! Cut all the red wires with your scalpel before it blows up. If you cut a white wire, it blows up.

Miracle at 9,800 Feet
Difficulty Rating 2

In this operation, you will get turbulence. This starts out as a mild shaking, a warning to finish up the procedures you are doing. First, disinfect and incise. The lung will appear normal. Use the ultrasound to look around it. There should be small black marks appearing under the ultrasound. Use the knife to open the area, like in a tumor. Drain the fluid, like a tumor again. Now just use the antibiotic gel to close the incision. Do this for all of the liquid pockets. If the screen begins to shake, finish up any liquid draining. If any wounds or liquids are still out, it will inflame the surrounding areas. Inject anti inflammatory and continue. When the shaking is really violent, doing anything will result in a miss. You don't need to get all of the liquid pockets, just keep removing them until Angie tells you to finish up. Now, suture, disinfect, and bandage.

Forbidden Knowledge
Difficulty Rating 3

This GUILT is Triti. Triti has two basic strategies to keep in mind shile operating. The first takes a long time, is a little easier and slower and the second is much faster, but requires much more speed and ability. The two strategies will be called for your convenience

1.Siege

2.Flash

Siege:Forbidden Knowledge
Begin by disinfecting the incision, and cutting it. You will see the pancreas with the triangular triti. A few things to keep in mind, you must remove all the thorns on a triangle in order to excise it, if a triangle is isolated it will reproduce, and if two thorns are next to each other and there is a free slot, it will reproduce into that slot. Now take the forceps and begin to remove some thorns. You can use the healing touch at anytime in this operation. Once you have all the thorns from a few triangles, take the scalpel and cut all of the yellow excise marks. There is no need to do it in a triangle pattern. Now, quickly remove the triangles with the forceps before more thorns appear to kold them in place. Keep doing this and eventually, you will have, a big sized block of triangles in the upper left hand corner. Slowly excise blocks of 3 or 4 triangles until you are left with 3 to 4 triangles left. Remember to not let triangle thorns get side by side to stop them from reproducing. Now, remove all the thorns as fast as you can and excise them quickly. The last one, if you can't get rid of it fast enough, will reproduce. Keep doing this part until you succeed. Now, suture the incision, disinfect, and finally bandage.

Flash:Forbidden Knowledge
All right. First read the above strategy for some basic information on Triti. This strategy involves using the healing touch to stop it's reproduction. Now, disinfect the guideline. Perform the incision. Double-tap the hand icon and use the healing touch. Twenty to twenty-one hundred should be good enough. Now take the forceps, and pull out all of the thorns as fast as you can. In the healing touch, triti can't make more thorns. Now get the scalpel and slice all of the yellow marks. No need to do it in a triangle. The game will only care if you get the knife on the marks. Now get the forceps again. Grab all of the triangles and put them into the tray. If by any chance the game come out of healing touch during this step, continue removing them but you will need to use the forceps to take out thorns again if more appear. Once the triti has been eradicated, suture the incision, disinfect, and bandage.

Race For the Cure
Difficulty rating 2

This part of the story involves more than one operation. The operations will vary slightly, but can be treated with the same method. Begin by choosing one of the locations on the map. You will need to get the antigen of all three types of Tetarti.

Begin by disinfecting the guideline and cutting it. There will be a GUILT parasite on the organ. Use the syringe to inject it with the medicine. It will burrow back into the organ like Kyriaki. You also get it back out the same way, use the ultrasound to find it and cut it out. Inject it with the serum again once it has stopped flashing. Repeat this process until the parasite is dead. Use the forceps to drag it onto the tray, and then cut it open. Use the drain to remove it's body fluids, then treat all of the wounds and close the patient up.

Stepping Up
Difficulty rating 3

Disinfect the guideline and perform the incision. There will be 3 small tumors which will grow in size. Once you can clearly see what color the tumors are, select the syringe and inject them with the correspondent colors. Once enough has been injected, the yellow excision line will appear. Cut it, and remove it with forceps. Do this all at once for the three tumors, since if they get too big, they will explode and release toxic gases. Apply the synthetic membrane on the wounds, disinfect with with the antibiotic gel, and mend it with the hands. Now, the three Tetarti wil appear. They are all synchronized and act as one GUILT, so you have to inject all three of them for any effect. Memorize the colors of each one, yellow, green, and purple. Once they have become transparent, inject each one with the serum of it's appropriate color. If you inject all three, they will burrow back into the liver, but if you can't they may make more tumors which you will have to treat at the end of the operation. They will come back, so repeat this procedure until the Tetarti has been eliminated. Treat any wounds, and close the pacient up.

What is GUILT?
GUILT is a form of medical terrorism in trauma center. It uses parasites and diseases to turn the human body against itself and finally kill the host. The government is stopping people except those who have the disease and those who research and attempt to treat it from knowing about it. It is made by the medical terrorism group Delphi, named after the greek oracle. Each of the seven GUILT is named after a greek day of the week.

Kyriaki

Deftera

Tetarti

Triti

Pempti

Parakevi

Savato