Guide:Surgery

This is a guide to perform surgery. It is advised to have more than ten of each tool to begin surgery, especially when coming across difficult surgeries such as Massive Trauma or Deep Brain Tumor.

A player can perform surgery on another player if the latter is standing on a Hospital Bed or Starship Sickbay Bed, and is not currently recovering. By using the Wrench and clicking the "Perform Surgery" button, the player can perform surgery on the other player. A Surg-E or Train-E is also available for players to be able to perform surgery without having other players as their patients.

Tools

These are all the tools required to do surgery. Not every tool is required to complete surgery but it is advised that players carry each tool in case they are required during surgery.

Tool	Use
Surgical Sponge	Used when the surgery screen says "You can't see what you are doing!" In this case, the player is forced to use the Surgical Sponge. Can also be used when it says "It's becoming hard to see."
Surgical Splint	Used to fix fractures. If the patient has a broken bone, use this to remove it.
Surgical Antiseptic	Used to clean the operation site. If the operation site is unsanitary, this can be used to make it clean. If not used, it may increase the patient's temperature.
Surgical Antibiotics	Used when the patient has a fever. If the surgery screen says "Patient's fever is climbing," this can be used to lower the temperature.
Surgical Anesthetic	Used to put a patient to sleep, turning its Awake status to Unconscious. Used before Surgical Scalpel, if not, the player will fail the surgery.
Surgical Scalpel	Used to cut open the patient. This tool is usually used until the "Fix it" button has appeared. It is also to be used before fixing a shattered bone.
Surgical Stitches	Used to stop the patient from bleeding or close up incisions. This tool is usually used when the patient is losing blood before a Surgical Scalpel has been used or after the "Fix it" button when the player's incisions need to be stitched up.
Surgical Lab Kit	Used to unlock Surgical Antibiotics. Surgical Antibiotics cannot be used before using this tool.
Surgical Clamp	Used to clamp up blood vessels. If the patient is losing blood before the "Fix it" button can be used, this tool can be used to stop the patient from losing blood. It can only be used if the patient has at least one incision.
Surgical Pins	Used to fix shattered bones. When used, a shattered bone turns into a broken bone. This item can only be used when the patient has at least one incision.
Surgical Transfusion	Used to transfuse several pints of blood into a patient. When the pulse of a player is weak or extremely weak, this will turn the pulse back to steady or strong.
Surgical Ultrasound	Used to diagnose a patient. The player will not know what condition the patient has if this is not used. It will reveal physical issues of the patient and other tools needed for the surgery.
Surgical Defibrillator	Used to shock a patient back to life. If the patient's heart has stopped, this must be given to the patient otherwise surgery cannot continue.
Empty Surgery Tray	Unobtainable by players, used as an icon for when the player is missing a tool.

Item Pack

The Surgical Kit, which contains 5 of all the needed tools, is available in the Store for 12,000 gems.

Skill Fail/Surgeon Skill

Skill Fail is a randomly-generating mechanism designed to make surgery harder. During surgery, the surgeon may fail to use a tool properly. In the event of a skill fail, the player is required to do that step again before continuing. If a player's Surgeon Skill is higher, the player will receive less skill fails. Players with a low Surgeon Skill will face more skill fails and is part of the learning process to becoming better at surgery. Players with a Surgeon Skill of 100 can still face skill fails, however, the chances are extremely low.

The following messages will appear if the player has received a skill fail for a particular tool used:

Surgical Lab Kit - "You contaminated the sample."
Surgical Antibiotics - "This is the wrong medication! The bacteria like it."
Surgical Transfusion - "You spilled all of it! Kind of gross."
Surgical Antiseptic - "You spilled antiseptic on your shoes. They are very clean now."
Surgical Sponge - "You somehow managed to eat the sponge."
Surgical Stitches - "You somehow tied yourself up in stitches!"
Surgical Anesthetic - "You end up inhaling all the anesthetic yourself. You feel woozy."
Surgical Ultrasound - "You scanned the nurse with your ultrasound!"
Surgical Defibrillator - "You electrocuted yourself!"
Surgical Splint - "You ate a splint, good job!" or "You cut the patient." (this results in the patient starting to bleed a little)
Surgical Pins - "You jabbed the pin through the artery!"
Surgical Clamp - "The clamp fell out of your hand, oh well."
Surgical Scalpel - "This will leave a nasty scar, but you managed to cut the right place." (this results in the patient starting to bleed)
Fix it - "You screwed it up! Try again."

Types of Problems

Before conducting any surgery on a patient, all problems before the surgery has begun must be addressed.

If the patient's temperature is rising, Surgical Lab Kit must be used to unlock the Surgical Antibiotics which is then given to the patient.

If the patient is rapidly losing blood, Surgical Stitches must be given to the patient.

If the patient has a weak pulse, Surgical Transfusion must be given to the patient.

If the patient has any broken bones, Surgical Splint must be given to the patient.

If the patient's heart has stopped, Surgical Defibrillator must be given to the patient. If any surgical skill fail has occurred, the step must be repeated.
If the patient is losing blood during an incision, Surgical Clamp must be given to the paint. This is best in avoid you stitch up the patient when you are in the middle of finding their problem to Fix.

Once all this has been done, the Surgical Ultrasound can be used to find the problem. All steps shown below are to be done AFTER the Surgical Ultrasound (Surgical Lab Kit in some cases) displays the problem. If during any of these steps, the patient's heart stops, starts bleeding or any other problem occurs, address these problems using the appropriate tools FIRST before continuing. If the patient wakes up during surgery, use Surgical Anesthetic to put them back to sleep. If any surgical skill fail has occurred, the step must be repeated (except for Surgical Scalpels).

Types of Unreported Problems

Sometimes, during a surgery. You can’t help wondering why a patient died when you thought you were doing great, here are examples of Unreported Problems only visible when you are observing the chatbox.

”the patient screams and flails!!” means you are undergoing a surgery with a conscious patient having not less than one incision. When you’ve cut open something with a Surgical Scalpel afterwards getting the patient back awake. He will feel pain from the unstitched incision and will later fail from ”The patient has bled out!”. This however, can be solved by putting the patient back to sleep with Surgical Anesthetic or stitching away the pain with Surgical Stitches.

Broken Leg

Problem	Steps to fix
Broken Arm	Use Surgical Splint to fix the broken bones. Use Surgical Stitches to reduce bleeding.
Broken Leg	Use Surgical Splint to fix the broken bones. Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel. Use Surgical Pins to fix any of the shattered bones. Close up the incisions made using Surgical Stitches and use a Surgical Splint to fix the broken bones.
Bird Flu/Turtle Flu/Monkey Flu	Use Surgical Lab Kit to unlock Surgical Antibiotics and use until the patient's temperature is no longer rising.
Nose Job	Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel until the Fix it button appears (usually once). Select the Fix it button and use Surgical Stitches to close up the incisions.
Lung Tumor	Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel until the Fix it button appears (usually once). Select the Fix it button and use Surgical Stitches to close up the incisions.
Heart Attack	Use Surgical Antibiotics (optional) until temperature is at 98.6. Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel until the Fix it button appears (usually twice). Select the Fix it button and use Surgical Stitches to close up the incisions.
Brain Tumor	Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel until the Fix it button appears (usually five times). Select the Fix it button and use Surgical Stitches to close up the incisions.
Liver Infection	Use Surgical Antibiotics until temperature reaches 98.6. Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel until the Fix it button appears (usually twice). Select the Fix it button and use Surgical Stitches to close up the incisions.
Kidney Failure	Use Surgical Antibiotics until temperature is at 98.6. Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel until the Fix it button appears (usually twice). Select the Fix it button and use Surgical Stitches to close up the incisions.
Appendicitis	Use Surgical Antibiotics until temperature is at 98.6. Use Surgical Antiseptic until site is clean. Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel until the Fix it button appears (usually three times). Select the Fix it button and use Surgical Stitches to close up the incisions. If patient's temperate rises above 100, use Surgical Antibiotics.
Swallowed a World Lock	Use Surgical Antibiotics until temperature is at 98.6. Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel until the Fix it button appears (usually twice). Select the Fix it button and use Surgical Stitches to close up the incisions.
Herniated Disc/Damaged spine	Use Surgical Antibiotics until temperature is at 98.6. Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel until the Fix it button appears (usually three times). Select the Fix it button and use Surgical Stitches to close up the incisions.
Broken Everything/Run over by a truck	Use Surgical Antibiotics until temperature is at 98.6. Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel until the Fix it button appears. Select the Fix it button and use Surgical Pins to fix the shattered bones and use Surgical Splint afterward. If the patient wakes up, use the Surgical Anesthetic again. Close up the incisions using Surgical Stitches and use the Surgical Splints to repair the broken bones.
Serious Head Injury	Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel until the Fix it button appears (usually once). Select the Fix it button and use Surgical Stitches to close up the incisions.
Serious Trauma with a punctured lung	Use Surgical Splint to fix all the broken bones. Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel until the Fix it button appears (usually twice). Use Surgical Stitches to close up the incisions until one remains (to reduce bleeding). Use Surgical Pins to fix the shattered bones and close the remaining incision using Surgical Stitches. Use Surgical Splint until the patient no longer has any broken bones.
Massive Trauma	Use Surgical Splint to fix all the broken bones. Put the patient to sleep using Surgical Anesthetic and cut the patient open using a Surgical Scalpel until the Fix it button appears (usually three times). Use Surgical Stitches to close up the incisions until one remains (to reduce bleeding). Use Surgical Pins to fix the shattered bones and close the remaining incision using Surgical Stitches. Use Surgical Splint until the patient no longer has any broken bones.
Torn Muscle Punching	Use Surgical Antiseptic until the operation room is clean. Use Surgical Anesthetic to put the patient to sleep. Use Surgical Scalpel to cut open the patient until the Fix it button appears (usually once). Use Surgical Stitches to close the incision.
Gem Cuts	Use Surgical Anesthetic to put patient to sleep. Use Surgical Scalpel (twice) until the message:"You have examined the wounds" appears. Select the Fix It button and use Surgical Stitches until no more incisions.
Broken Heart	Use Surgical Lab Kit to unlock Surgical Antibiotics and use until temperature is at 98.6. Put the patient to sleep using Surgical Anesthetic. Use Surgical Scalpel until Fix it appears. Use Surgical Pins twice on the broken bones. Use Surgical Stitches until no incisions. In case the patient's heart stops, use Surgical Defibrillator. Use Surgical Splint until no more bones are shattered.

Other Conditions

During surgery, some patients may have special conditions on top of their problems. This makes the patient harder to perform surgery on and a higher chance of failing. They include:

"The patient exhibits very tough skin. Possibly a superhero." - requires an extra use of a Surgical Scalpel before the Fix it button appears.
"The patient has an antibiotic-resistant infection." - Surgical Antibiotics reduce the temperature of the patient less.
"The patient is absolutely filthy." - requires extra use of Surgical Sponges during surgery to clean up the patient.
"The patient is hyperactive." - patient wakes up a little earlier after being giving Surgical Anesthetic.
"The patient is a hemophiliac." - the patient will bleed faster than normal.

Rewards

Upon completing surgery, the player will directly receive a prize. Some of the rewards are much rarer than the rest. If a player receives a common prize, the player will also be rewarded with a Caduceus, which can later be traded in for items when calling the Sales-Man using a Telephone.

Among the possible prizes are:

Any Surgical Tool x5
Scrub Mask
Scrub Top
Scrub Pants
Scrub Cap
Candy Striper Cap
Candy Striper Skirt
Candy Striper Uniform
Hospital Wall x10
Hospital Curtain x5
Hospital Window x5
Hospital Door x5
Hospital Bed
Holographic Sign
Antidote
Homeopathic Medicine
g-Virus
Steel Spike
Autoclave
DNA Processor
Wolf Whistle
Cybernetic Eye
Techno Visor
Skateboard
Rayman's Hair (while wearing a Pirate Hat)
Winter Flu Vaccine (only obtainable during WinterFest)
Tree Decorations (only obtainable during WinterFest)
Pineapple Engine Part (only obtainable during Super Pineapple Party)
Medical Scarf
Edison Zoomster
Anubis Mail
Magnifying Glass
Thingamabob
Healing Tome
Vaccine Drop
Plague Doctor Hat (only obtainable during Surgery Day)
Plague Doctor Robe (only obtainable during Surgery Day)
Plague Doctor Mask (only obtainable during Surgery Day)
Punchy Fist (curing Torn Punching Muscle malady)
Gem Hair (curing Gem Cuts malady)

If the player has successfully performed surgery on the patient, the patient will receive 100 gems.

There are also exclusive rewards obtainable from doing a surgery on a player standing on a Starship Sickbay Bed. The possible prizes are:

Mods

Malpractice - If the player fails or gives up any surgery, the player is unable to do surgery for the next hour (can be removed instantly using Legal Briefs). Reduced to 30 minutes during Surgery Day.
Recovering - If the player has had surgery (failed or not), the player cannot have surgery performed on them for the next four hours. Reduced for an hour during Surgery Day.

Events

In the Doctors' Duel Daily Challenge, players compete to complete the most successful surgeries in two hours (50 points per surgery and -1 point per tool used).

There is also a Surgery Day where both the Malpractice and Recovering mods are shorter than usual. Special prizes such as the Plague Doctor Mask can also be obtained during this day.

During a Surgeon Day, the points one earns after completing a Surgeon role quest is increased by 25%. Doing so for the first time of the day will reward a Growtoken.

Additional Tips

Before surgery, it is heavily advised that players have enough backpack space to collect their prize. Otherwise, they will fall on the ground, allowing other players to pick them up.
A surgery is possible to be done without the use of Surgical Antiseptic. This is not recommended, however, for players with a low skill level.
It is advised for any player new to surgery to do the easier surgeries. When the player has reached Surgeon Skill 100, they can attempt harder surgeries such as Massive Trauma.
Players can use Tea, a consumable which reduces the chance of skill fail for 2 minutes.
Using the Fix It button is not necessary straight away as it appears. It can be used after all the incisions have been closed to reduce the chance of failing.
During Surgery Day, make sure to use Med-A-Check to check the malady of the patient.

Trivia

Players can talk during surgery by clicking any of the blank tools and quickly pressing the chat button (or the Enter button).
Players can trade in the Caduceus they earn from receiving common prizes from surgery to the Sales-Man for rarer items, such as the Thingamabob and Medical Scarf. They may also receive either a Sales-Man Standee or the Sales Shades after purchasing.
Successfully performing a Massive Trauma surgery for the first time completes an Epic Quest.

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