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A Guide to Surgery

A full set of surgery tools can be found in each Operating Theatre locker at the start of the round, though they are often moved into a bag near the operating table by surgeons. Once a surgery has been initiated, the nearby operating computer will give you a hint towards the next step. For Synthetic surgery, see Here.

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.

The Standard Surgical Equipment
Scalpel Creates incisions and debrides.	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.	FixOVein Mends ruptured arteries and veins.	Circular Saw Saws through bone and amputates limbs.	Surgical Drill Creates cavity spaces for implants.	Anesthetic Tank Anesthetizes patients.
Additional Optional Equipment
Man-Machine Interface Provides storage for brains.	Sterile Mask Prevents infections.	Latex Gloves Prevents infections.	Advanced Laser Scalpel A scalpel, hemostat, and cautery all in one.	Incision Management System An ALS with retractor functionality. Retractor fuctionality takes precedence over hemostat.

Ghetto Surgery

Surgery can also be performed with other tools if proper surgical implements are not readily available. Use of these tools can dramatically decrease the likelihood of successfully completing a step, often causing collateral damage, especially when attempting to make the initial incision. Furthermore, surgical procedures can be performed on surfaces similar to an operating table, at the cost of additional chance of failure. Tool and surface success chance modifiers combine multiplicatively.

Ghetto Surgical Equipment
Regular Equipment	Substitutes (Hover over the items sprite to see success rate)
Scalpel	Kitchen Knife 90% success rate (PLASTIC SURGERY ONLY) 50% success rate	Glass Shard File:Glass Shard Medium.png 60% success rate	Wirecutters (PLASTIC SURGERY ONLY) 35% success rate	Scissors (CANT PERFORM DEBRIDEMENT) 12% success rate	Claymore (CANT PERFORM DEBRIDEMENT) 6% success rate	Energyaxe (CANT PERFORM DEBRIDEMENT) 6% success rate	Edagger (CANT PERFORM DEBRIDEMENT) 6% success rate	Chainsaw (CANT PERFORM DEBRIDEMENT) 1% success rate
Hemostat	Cable Coil 90% success rate	Fork (INTERNAL ORGAN REMOVAL ONLY) 70% success rate	Crowbar (BIO-CHIP REMOVAL ONLY) 65% success rate	Mouse Trap 25% success rate
Retractors	Crowbar 90% success rate	Fork 60% success rate
Bone Gel	Screwdriver 90% success rate
Bone Setter	Wrench 90% success rate
Cautery	Cigarette 90% success rate	Lighter 60% success rate	Welding Tool 30% success rate
FixOVein	Cable Coil 90% success rate
Circular Saw	Hatchet 90% success rate	Armblade (AMPUTATION SURGERY ONLY) 75% success rate
Surgical Drill	Hand Drill (CAVITY SURGERY ONLY) 90% success rate (DENTAL SURGERY ONLY) 80% success rate	Pen (CAVITY SURGERY ONLY) 90% success rate	Exosuit Drill (DENTAL SURGERY ONLY) 90% success rate	Metal Rods (CAVITY SURGERY ONLY) 60% success rate	Mining Drill (DENTALSURGERY ONLY) 60% success rate	Screwdriver 1% success rate
Operating Table	Holo Stretchers 90% success rate	Roller Beds 80% success rate	Tables 80% success rate	Beds 70% success rate	Default File:Floor.png 50% success rate

Preventing 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 and sterile masks.
• Improper storage of transplantable limbs/organs.
• Multiple people in a single operating theatre.

Failure to keep an operating theatre and its equipment clean 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 during the organ manipulation surgery.

Prepping for Surgery

Now that you understand the basics of both surgical tools and infections it's time to prep for performing the surgery itself. Make sure you diagnose what's wrong with the patient prior to attempting surgery via the use of the Advanced Body Scanner. There are also a few caveats to surgical prep work such as:

• The patient should be healed as much as possible prior to surgical intervention, as many surgeries won't take when performed on severely injured persons.
• All patients require some form of anesthetic, such as the anesthetic tank, ether, or hydrdocodone. Failure to use anesthetic will increase the chance of failure on each step.
• If the patient is a Vox or Plasmaman do not administer tank-based anesthetic. In the case of Vox and Plasmamen, removing their internals can be fatal.

The following is a list of steps to prep for surgical procedures. Please ensure you diagnose your patient prior to prepping for surgical intervention.

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 and Vox 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 the anesthetics 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.

Basic Surgeries

While there are a number of surgical procedures one can perform, the following are some of the most common procedures that are simple and require only basic tools.

Amputation
Removal of limbs or head.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the target limb using the Damage Zone.
3. Use the Scalpel or Circular Saw to select the "Limb Attachment" Surgery.
4. Use the Circular Saw to Amputate the limb.

Bio-chip Removal
Removing bio-chips such as mindshields, death alarms, mindslaves, and other bio-chips 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 "Bio-chip 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. Hold a Bio-chip Case in your other hand for the next step to put the bio-chip into a case.
7. Use your Hemostat to extract the bio-chip.
8. Use the Cautery to seal the incision.

External Infection Treatment
Removing infections on limbs.

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.

• If an organ is infected you will have to administer spaceacillin or douse it in alcohol with a high ethanol content. If the organ is septic, it will require transplantation.

Limb Attachment Surgery
Re-attaching severed limbs

1. (Optional) Complete Prepping for Surgery.
2. Aim for the patient's affected (missing) limb using the Damage Zone.
3. Use the Scalpel to select the "Limb Attachment" Surgery.
4. Attach the appropriate missing limb (theirs or someone elses).
5. 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 procedure.

Plastic Surgery
Fixing facial Disfigurement and changing Identity.

1. (Optional) Complete Prepping for Surgery.
2. Aim for the patient's head in the Damage Zone.
3. Use the Scalpel to select the "Plastic Surgery" Surgery.
4. Use the Scalpel again to begin the incision.
5. Use the Hemostat to stop any potential bleeding.
6. Use your Retractor to lift up the skin.
7. Use the Scalpel to reshape the face and vocal chords.
8. Use the Cautery to seal the incision.

• Performing the surgery on a Disfigured face will repair, on a Normal face will give a list of random, species-appropriate names to change identity.
• Note that this does not repair "husked" appearance as the result of excessive Burn damage.
• Any ID cards on the patient or surgeon will also have their registered name added to the available names list.

Intermediate Surgeries

These surgeries use more equipment compared to the Basic Surgeries and take a bit longer.

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.

Debridement and Limb Revival
Reviving dead 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.

• While bottles and buckets may be used, droppers are more effective (can not fail). The container must have mitocholide in it.

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.

Internal Organ Manipulation
Mending, inserting, and removing internal organs and cybernetic implants. Also fixes bones, and is used to remove xenomorph larva, bone tumors, or terror spider eggs.

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 Circular 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.

In the case of replacing "Fleshy mess" from a victim of an abductor make sure to have a spare heart and a defibrillator ready.

1. When finished:Use the Retractor to close the ribcage/skull/skin.
2. Apply Bone Gel to help mend the ribcage/skull [CHEST/HEAD ONLY].
3. Use the Bone Setter to finish mending the ribcage/skull [CHEST/HEAD ONLY].
4. Apply Bone Gel to help mend the ribcage/skull [CHEST/HEAD ONLY].
5. Use the Cautery to seal the incision.

Limb Augmentation
Augment limb with robotic part.

1. Aim for the chest or limbs in the Damage Zone.
2. Use the Scalpel to select the "Augment Limb" Surgery.
3. Use the Scalpel again to begin the incision.
4. Use the Hemostat to stop any potential bleeding.
5. Use the Retractorto lift up the skin.
6. While holding a cyborg arm, leg, or chest; Insert the item inside.

Advanced Surgeries

There's also a bevy of other surgeries that can be performed even if niche in purpose.

Alien Organ Manipulation
Extracting or manipulating the organs of a Xenomorph.

1. Aim for the chest, head, groin, eyes, or mouth in the Damage Zone.
2. Use the Scalpel or the Circular Saw to select the "Alien Organ Manipulation" Surgery.
3. Use the Circular Saw to saw its carapace.
4. Use the Scalpel to cut its carapace.
5. Use the Retractor to retract its carapace.
6. Here, you can manipulate the organs, by either using the Hemostat to remove them, Trauma Kit to heal them, a reagent container filled with an alcoholic reagent to disinfect them, or simply transferring new organs inside.

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 autopsy scanner to scan the area.
5. Repeat scan procedure for all affected areas.
6. Right click the autopsy scanner to print out autopsy data.

Brain Removal
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 or Circular Saw to scrape out the Brain and other organs.

Cavity Surgery
Implanting a variety of objects into an artificial body cavity.

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. [HEAD AND CHEST ONLY] Use the Circular Saw to cut through the bone.
7. [HEAD AND CHEST ONLY] Use the Retractor to pull back the bone.
8. [GROIN ONLY] Use the Scalpel to make an internal incision into the abdominal wall.
9. Use the Surgical Drill to prepare the cavity.
10. While holding an Item:Insert the item inside. If it caused internal bleeding, use FixOVein internal bleeding surgery to fix it.
11. With an open hand: Click the patient to check for items inside the cavity.
12. When done use Cautery twice to mend cavity wall.
13. [HEAD AND CHEST ONLY] Use the Retractors to close their ribcage.
14. [HEAD AND CHEST ONLY] Apply Bone Gel to mend the cut ribcage.
15. [HEAD AND CHEST ONLY] Use the Bone Setter to mend the ribcage.
16. [HEAD AND CHEST ONLY] Apply Bone Gel to mend the cut ribcage.
17. Use the Cautery to seal the incision.

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.

Embedded Object Removal
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 Circular Saw to open the ribcage/skull. [CHEST/HEAD ONLY]
8. Use the Retractor to pull their ribcage/skull open. [CHEST/HEAD ONLY]
9. With an empty hand: Click the patient to remove the embedded object.
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.

Robotics Surgeries

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.

Bio-chip Removal (Synthethics)
Removing bio-chips from the body.

1. Aim for the bio-chip location on the Damage Zone;
2. Use the Screwdriver to select the "Bio-chip 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 Wirecutters to extract the bio-chip. This may take several goes;
6. Use Crowbar to close the hatch on the limb

Cybernetic Repair
Fixing mechanical arms, legs, hands and feet.

1. Aim for the patient's correct Damage Zone;
2. Use the Screwdriver to select the "Cybernetic Repair" 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 a Welding tool to repair Brute damage and use Cable coil to repair burn damage;
6. Use a Crowbar to close the hatch on the limb

Identity Configuration
Renaming and Re-Gendering

1. Aim for the patient's correct Damage Zone;
2. Use the Screwdriver to select the "Identity Reconfiguration" 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 a Multitool to reprogram the identity;
6. Type in a new name and select the correct Gender.
7. Use a Crowbar to close the hatch on the limb

Cybernetic Appearance Customization
For when the Unbranded style doesn't look good after all.

1. Aim for the patient's correct Damage Zone;
2. Use the Screwdriver to select the "Cybernetic Appearance Customization" 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 a Multitool to reprogram the limbs appearance;
6. Select the company appearance. The most common appearance among IPCs being Morpheus Cybernetics;
7. Use a Crowbar to close the hatch on the limb

Internal Component 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. (Optional) Use a Multitool to remove Components. For Borgification simply remove the Positronic brain and place the positronic brain in an empty cyborg exoskeleton, or give the positronic brain to a Roboticist.
6. (Optional) While holding a Component or Implant: Insert the Component inside;
7. (Optional) While holding a Positronic Brain, or a Man Machine Interface: Insert the brain inside;
8. Repair the affected component with Nanopaste, or alternatively use a Screwdriver.
9. (Optional) Use a Welding tool to repair Brute damage and use Cable coil to repair burn damage;
10. Use a Crowbar to close the hatch on the limb

Robotic Cavity Implant/Removal
Removal of Items from robotic body cavities, sometimes confused with Internal Component Manipulation or Bio-chip Removal.

1. Aim for the implant location on the Damage Zone;
2. Use the Screwdriver to select the "Robotic Cavity 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. (Insertion) While holding an Item: Insert the item inside;
6. (Extraction) With an open hand: Click the patient to check for items inside the cavity;
7. Use a Welder to mend the cavity;
8. Use a Crowbar to close the hatch on the limb

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. Aim for the patient's correct Damage Zone;
2. Use the Screwdriver to select the "Robotic Limb Amputation" Surgery;
3. Use a Multitool to remove the targeted limb

Robotic Limb Attachment
"I can't believe that playing card chopped off my left arm!" - ARMA-732

1. Aim for the patient's correct Damage Zone;
2. (Optional) Use the Screwdriver to select the "Apply Robotic or Synthetic Limb" Surgery;
3. Apply the robotic limb, or a new limb printed from your Exosuit Fabricator