Surgery

=A Guide to Surgery=

All surgery requires the set of medical tools in the Operating Theatre, along with an operating table. Once a surgery has been initiated, the nearby operating computer will give you a hint towards the next step.

Surgical Tools

Every operating theatre is equipped with a full suite of surgical tools. In the event that surgical tools go missing, you can either have them manufactured at an autolathe or order them from Cargo.

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The following are the standard surgical tools most doctors will need:

• Scalpel: Creates & mends incisions.
• Hemostat: Ties bleeders, and removes objects.
• Retractors: Opens incisions and cavities.
• Bone Setter: Sets broken bones in place.
• Bone Gel: Mends broken bones back together.
• Cautery: Cauterizes incisions and debrides.
• FixOVein: Mends ruptured arteries and veins.
• Circular Saw: Saws through bone and amputates limbs.
• Surgical Drill: Creates cavity spaces for implants.
• File:Mmi empty.png MMI: Provides storage for brains.
• Autopsy Scanner: Provides autopsy results.
• Anesthetic Tank: Anesthetizes patients.
• Sterile Mask: Prevents infections.
• Latex Gloves: Prevents infections.
• Incision Management System: A scalpel, hemostat, retractor, and cautery all in one.
• Advanced Laser Scalpel: A scalpel that can also serve as a cautery.

Ghetto Surgery

Surgery can also be performed with other tools if proper surgical implements are not readily available. Use of these tools dramatically decreases the likelihood of successfully completing a step and often causes collateral damage, especially when attempting to make the initial incision. Furthermore, surgical procedures can be performed on tables and rollerbeds as well, with a 66% and 33% additional chance of failure respectively.

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The following are a list of non-standard surgical tools:

• Scalpel: Kitchen Knife (75%), Glass Shard (50%).
• Hemostat: Cable Coil (75%), Mouse Trap (20%).
• Retractors: Crowbar (75%), Fork (50%).
• Bone Gel: Screwdriver (75%).
• Bone Setter: Wrench (75%).
• Cautery: Lit Cigarette (75%), Zippo Lighter (50%), Lit Welding Tool (25%).
• FixOVein: Cable Coil (95%).
• Circular Saw: Hatchet (75%).
• Surgical Drill: Pen (75%), Metal Rods (50%).

Infection

Infections can be caused by a myriad of sources, from untreated burns to uncleanly surgical tools. The following factors contribute to the likelihood of a surgical procedure causing infection: unhygienic surroundings (including blood and debris), dirty surgical tools, unwashed hands, improper/absent usage of sterile gloves, improper/absent usage of sterile masks, improper storage of transplantable limbs/organs, and multiple people in a single operating theatre.

Failure to keep an operating theatre and its tools clean, along with adequate use of protective equipment (gloves, masks) will result in infection. It is paramount that every surgeon practices adequate hygiene and safety precautions, limits the active number of patients in their theatre to one, washes their hands between every surgery, and keeps the operating theatre sterile.

If a patient manages to contract - or is presently suffering from - an infection administer spaceacillin. In lieu of spaceacillin, compounds containing high levels of ethanol (preferably straight ethanol) can be used to disinfect organs.

Prepping for Surgery

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Please ensure that you have properly diagnosed your patient prior to prepping for a surgical procedure.

1. Find a suitable operating table. In absence of an operating table, a rollerbed or table may be used (with a higher likelihood of surgical errors).
2. Make sure you're wearing latex gloves and a sterile mask.
3. Use a sink to wash your hands. Unclean hands can result in infections.
4. Click+drag the person to the operating table to lay them down on it.
5. Check to ensure whether or not your patient is able to be safely anesthetized. Species such as Plasmamen, Vox, and Slime People can not be anesthetized and will optionally require ether, morphine (addictive), salicylic acid, or hydrocodone.
6. Pick up a medical mask and anesthetic tank.
7. Click+drag their body onto yours to view their inventory. Click on the link beside "Mask" to remove their mask if they have one. Do the same for the link beside "Back" to remove their backpack.
8. With the medical mask in your active hand click on the "Nothing" link at the top beside "Head (Mask)". In a few seconds, you will equip them with the medical mask.
9. Place the anesthetic tank in your active hand, then click the "Nothing" link in their inventory window beside "Back" to equip it on their back.
10. A new link will appear beside the sleeping agent called "Set internals". Click on it to turn on the gas. It will force them asleep in about 5 seconds. You are now ready to proceed with surgery.
11. Make sure you're set on the Help intent.

• If anyone is pulling on the patient, the surgery will not work properly. Make sure no one is pulling the patient.

• Make sure the patient is not a Vox, Plasmaman or Slime Person before you attempt to administer anesthetic.

• Make sure the patient has been healed prior to bone repair or organ manipulation surgery, or it won't work.

Basic Surgery List

While there are a number of surgical procedures one can perform, the following are some of the most common procedures that every surgeon should familiarize themselves with.

• To stop a surgery at any point in time, hold the scalpel tool in your active hand and a cautery in your off-hand. You can also switch intents prior to making the first incision.

• Cybernetic Implant Surgery falls under Organ Manipulation Surgery.

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Bone Repair Surgery

The mending of broken bones and fractures

1. (Optional) Complete Prepping for Surgery.
2. Ensure the patient has been healed first, or the bones will break as soon as you fix them.
3. Aim for the afflicted limb in the Damage Zone.
4. Use the scalpel to select the "Bone Repair" Surgery.
5. Use the scalpel again to begin the incision
6. Use the hemostat to stop any potential bleeding.
7. Use your retractors to lift up the skin.
8. Apply bone gel to the broken bone.
9. Use the bone setter to put the bone in place.
10. Apply more bone gel.
11. Use the cautery to seal the incision.

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Internal Bleeding Surgery

Repairing damaged arteries and veins within the body to stop internal bleeding.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the afflicted limb in the Damage Zone.
3. Use the scalpel to select the "Internal Bleeding" Surgery.
4. Use the scalpel again to begin the incision
5. Use the hemostat to stop any potential bleeding.
6. Use your retractors to lift up the skin.
7. Use the FixOVein to repair the damaged blood vessels.
8. Use the cautery to seal the incision.

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Limb Attachment Surgery

Re-attaching severed organic and IPC limbs and heads

1. Aim for the patient's affected (missing) limb using the Damage Zone.
2. Use the scalpel to select the "Limb Attachment" Surgery.
3. Attach the appropriate missing limb (theirs or someone elses).
4. Use the hemostat to reconnect the nerves and muscles and finish. This step isn't needed for IPC limbs.

You can use the severed limbs of most humanoid mobs for this, EXPERIMENT!.

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Internal Organ Manipulation (Non-Synthetics)

Mending, inserting, and removing internal organs and cybernetic implants. Also fixes bones, and is used to remove alien babies. Applying ethanol can disinfect organs.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the correct Damage Zone.
3. Use the scalpel to select the "Organ Manipulation" Surgery.
4. Use the scalpel again to begin the incision
5. Use the hemostat to stop any potential bleeding.
6. Use the retractors to lift up the skin.
7. Use the saw to open the the ribcage/skull [CHEST/HEAD ONLY].
8. Use the retractor to pull their ribcage/skull open [CHEST/HEAD ONLY].
9. Here, you can manipulate the organs, by either using the hemostat to remove them, Trauma Kit or Nanopaste to heal them, a reagent container filled with an alcoholic reagent to disinfect them, or simply transferring new organs inside.
10. When finished:Use the retractor to close the ribcage/skull/skin.
11. Apply bone gel to help mend the ribcage/skull [CHEST/HEAD ONLY].
12. Use the Bone setter to finish mending the ribcage/skull [CHEST/HEAD ONLY].
13. Apply bone gel to help mend the ribcage/skull [CHEST/HEAD ONLY].
14. Use the cautery to seal the incision.

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Facial Reconstruction Surgery

The fixing of facial deformities.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the patient's head in the Damage Zone.
3. If you have a Incision Management System, use it for all steps except 9. Otherwise carry on as normal
4. Use the scalpel to select the "Face Repair" Surgery.
5. Use the scalpel again to begin the incision.
6. Use your retractor to lift up the skin.
7. Use your hemostat to reshape the face and vocal chords.
8. Use your retractor to pull skin back into place.
9. Use the cautery to seal the incision.

NOTE: You MUST end this surgery with only a cautery. The surgery won't work if you end it with a scalpel and cautery.

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Infection Treatment

Removing Infections. Pretty simple really.

1. Complete Prepping for Surgery.
2. Aim for the affected body part location on the Damage Zone.
3. Use the scalpel to select the "External Infection Treatment/Autopsy" Surgery.
4. Use the scalpel again to begin the incision
5. Use the cautery to seal the incision.

NOTE: If an organ is infected you will have to administer some spaceacilin, or use an alcoholic substance on it in a container (the higher the ethanol content, the better). Surgery won't be necessary in that case, as long as the other body parts are not infected, the substance might also remove other infections.

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Debridement and external organ revival (Limbs, not organs!)

Reviving dead external limbs

1. (Optional) Complete Prepping for Surgery.
2. Aim for the afflicted limb in the Damage Zone.
3. Use the scalpel to select the "Debridement" Surgery.
4. Use the scalpel again to begin the incision
5. Use the hemostat to stop any potential bleeding.
6. Use your retractors to lift up the skin.
7. Use the scalpel to debride the necrotic tissue.
8. Apply mitocholide using a container* to the organ to regenerate the removed tissue.
9. Use the cautery to seal the incision.

*NOTE: Everything from glasses to buckets to droppers can be used. Using droppers is more effective (can not fail) than just dumping a bucket on the wound. The container needs to have mitocholide in it.

Advanced Surgery List

There's also a bevy of other surgeries that whilst uncommon, can be extremely useful under certain circumstances.

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Cavity Surgery

Putting things inside and removing things from peoples' body cavities.

Maxiumum size of item that fits inside:

• Head - tiny (i.e. pen, paper)
• Abdomen - pocket-size (i.e. most surgical tools)
• Chest - small (i.e. bone saw, revolver)

1. Aim for the chest, abdomen or head in the Damage Zone.
2. Use the scalpel to select the "Cavity Implant/Removal" Surgery.
3. Use the scalpel again to begin the incision
4. Use the hemostat to stop any potential bleeding.
5. Use your retractors to lift up the skin.
6. [CHEST ONLY] Use the saw to open the ribcage.
7. [CHEST ONLY] Use the retractor to pull their ribcage open.
8. Use the surgical drill to prepare the cavity.
9. While holding an Item:Insert the item inside. If it caused internal bleeding, use FixOVein internal bleeding surgery to fix it.
10. With an open hand: Click the patient to check for items inside the cavity.
11. When done use cautery twice to mend cavity wall.
12. [CHEST ONLY] Use the retractor to close their ribcage.
13. [CHEST ONLY] Apply bone gel to mend the cut ribcage.
14. [CHEST ONLY] Use the Bone setter to mend the ribcage.
15. [CHEST ONLY] Apply bone gel to mend the cut ribcage.
16. Use the cautery to seal the incision.

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Dental Implant Surgery

Putting pills in your teeth.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the mouth Damage Zone.
3. Use the scalpel (or other surgery starter) to select the "Dental Implant" Surgery.
4. Use the surgical drill to prepare the tooth.
5. Insert the desired pill in the tooth.

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Embedded Object Removal (Non-Synthetics)

Removing embedded objects, typically bullets, from the body.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the embeded object location on the Damage Zone.
3. Use the scalpel to select the "Removal of Embedded Objects" Surgery.
4. Use the scalpel again to begin the incision
5. Use your hemostat to stop any potential bleeding.
6. Use your retractors to lift up the skin.
7. Use the saw to open the ribcage/skull. [CHEST/HEAD ONLY]
8. Use the retractor to pull their ribcage/skull open. [CHEST/HEAD ONLY]
9. Use the hemostat to extract the embeded objects.
10. Use the retractor to close their ribcage/skull. [CHEST/HEAD ONLY]
11. Apply bone gel to mend the cut ribcage/skull. [CHEST/HEAD ONLY]
12. Use the Bone setter to finish mending the ribcage/skull. [CHEST/HEAD ONLY]
13. Apply bone gel to mend the cut ribcage/skull. [CHEST/HEAD ONLY]
14. Use the cautery to seal the incision.

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Implant Removal (Non-Synthetics)

Removing Implants such as mindshield, death alarm, mindslave, and other implanter implanted implants from the body.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the chest on the Damage Zone.
3. Use the scalpel to select the "Implant Removal" Surgery.
4. Use the scalpel again to begin the incision
5. Use your hemostat to stop any potential bleeding.
6. Use your retractors to lift up the skin.
7. Use the saw to open the ribcage.
8. Use the retractor to force their ribcage open.
9. Use your hemostat to extract the implant.
10. Use the retractor to close their ribcage.
11. Apply bone gel to mend the cut ribcage.
12. Use the Bone setter to finish mending the ribcage.
13. Apply bone gel to mend the cut ribcage.
14. Use the cautery to seal the incision.

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Shadowling Dethrall

Removes the evil influence of shadowlings from a thrall. Converts a thrall back to a regular crewmember

1. (Optional) Complete Prepping for Surgery.
2. Aim for the head in the Damage Zone.
3. Use the scalpel to select the "Cleanse Contaminations" Surgery.
4. Use the scalpel again to begin the incision
5. Use the hemostat to stop any potential bleeding. (Hemostat will pinch the patient if the bleeders have already been clamped, in that case skip this step)
6. Use your retractors to lift up the skin.
7. Use the saw to cut through the skull.
8. Use the retractor to pry the skull open.
9. Use a flashlight or nearby handheld light-source to remove the shadowling tumor.
10. Use the retractor to close their skull.
11. Apply bone gel to mend the cut skull.
12. Use the Bone setter to mend the skull.
13. Apply bone gel to mend the cut skull.
14. Use the cautery to seal the incision.

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Autopsy

Examination of cadavers to find cause of death. See autopsy prodedures for more information.

1. Place cadaver onto the operating table.
2. Scan the cadaver with a Health Analyer to find injured locations.
3. Aim for the patient's affected area in the Damage Zone.
4. Use the scalpel to select the "External Infection Treatment/Autopsy" Surgery.
5. Use the scalpel again to begin the incision
6. Use the autopsy scanner to scan the area.
7. Repeat scalpel and scan procedure for all affected areas.
8. Right click the autopsy scanner to print out autopsy data.

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Organ Removal (Decapitated Head)

Removing the eyes and brain of a decapitated head for transplant to a full body or man-machine interface.

1. With the head in your hand, use the scalpel to make an incision.
2. Use your retractors to peel the skin open.
3. Use the bone setter to crack the head open.
4. Use the hemostat and select the organ you want to remove.

Synthetic Surgery List

There are are also a number of procedures that can be performed on IPCs. IPCs don't feel pain and can't get infections, so don't worry about administering anesthetics or washing your hands.

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Internal Cybernetic Manipulation

Mending, removal, and insertion of posibrains, microbatteries, optical sensors, and implants.

1. Aim for the patient's correct Damage Zone.
2. Use the screwdriver to select the "Internal Cybernetic Manipulation" Surgery.
3. Use a screwdriver to unlock the hatch on the limb;
4. Use a crowbar to open the hatch on the limb;
5. [REMOVAL Option] Use a multitool to Remove the organ.
6. [REMOVAL] Dispose of the organ. For Borgification simply place the File:Posibrain.png Posibrain in an empty cyborg exoskeleton, or give the posibrain to a Roboticist.
7. [TRANSPLANTATION Option] Use the organ you intend to transplant on the patient.
8. [HEALING Option] Repair the affected organ with Nanopaste.
9. Use a crowbar to close the hatch on the limb

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Shadowling Dethrall (Synthethics)

Turning a thralled IPC back into a normal crewmember

1. Aim for the upper body in the Damage Zone.
2. Use the screwdriver to select the "Cleanse Contaminants" Surgery.
3. Use a screwdriver to unlock the hatch on the limb;
4. Use a crowbar to open the hatch on the upper body;
5. Use a flashlight or nearby handheld light-source to remove the shadowling tumor.
6. Use a crowbar to close the hatch on the upper body

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Implant Removal (Synthethics)

Removing implants from the body. Also removal of things from body cavities.

1. Aim for the implant location on the Damage Zone.
2. Use the screwdriver to select the "Implant Removal" Surgery.
3. Use a screwdriver to unlock the hatch on the limb;
4. Use a crowbar to open the hatch on the limb;
5. Use your hemostat to extract the implant. This may take several goes.
6. Use a crowbar to close the hatch on the limb

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Robotic Limb Repair

Fixing mechanical arms, legs, hands and feet. Also performs facial reconstruction if aiming for head.

1. Use the screwdriver to select the "Cybernetic Repair" Surgery.
2. Use a screwdriver to unlock the hatch on the limb;
3. Use a crowbar to open the hatch on the limb;
4. Use a welding tool to repair Brute damage then cable coil to repair burn damage;
5. Use a crowbar to close the hatch on the limb

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Robotic Limb Amputation

"173. IPC interns are not to be punished for incompetence by having their "limb privileges" revoked." - Things Comms Officer Jenkins is Not Allowed To Do in CentCom

1. Use the screwdriver to select the "Robotic Limb Amputation" Surgery.
2. Use a multitool to remove the targeted limb.