Trauma Center: Under the Knife 2 is a 2008 simulation video game developed by Vanguard for the Nintendo DS (DS), and published by Atlus. It is the fourth game in the Trauma Center series and a direct sequel to Trauma Center: Under the Knife (2005). Set three years after the events of Under the Knife, the plot follows protagonist Derek Stiles as he confronts not only the revival of terrorist organisation Delphi and its GUILT disease, but personal insecurities and corporate manipulation. The gameplay combines surgical simulation relying on the DS's touchscreen controls with a story told as a visual novel.
Under the Knife 2 was developed as a true mechanical and narrative sequel to the original game, using the same controls and gameplay style in contrast to the altered style of other games on the Wii. Daisuke Kanada and Masayuki Doi returned as director and character designer, alongside new co-director Hirokazu Toyama and composers Manabu Namiki and Noriyuki Kamikura. Reception of the game was generally positive, but many journalists noted a lack of innovation while praising its improvements over the original game. It also met with low sales in Japan and North America.
Gameplay
Trauma Center: Under the Knife 2 is a video game that combines surgical simulation gameplay with storytelling using non-interactive visual novel-style cutscenes using static scenes, character portraits, and text with rare voice clips. The top screen of the Nintendo DS (DS) is dedicated to story sequences and level statistics displayed as 2D artwork, while the bottom touch screen is dedicated to the operations themselves rendered using 3D models. Players take on the role of protagonist Derek Stiles, a young surgeon with a mystical ability called the Healing Touch. Each operation tasks players with curing the patient of one or multiple ailments within a time limit. Missions can be played on different difficulty settings, ranging from "Easy" to "Hard".
The ten available surgical tools—which range from a scalpel and a laser to ultrasound and a defibrillator to revive a patient whose vitals flatline—are required for different operations and injuries, selected using icons along the edges of the touch screen and manipulated using the DS stylus. The player heals both surface wounds and internal injuries with the tools available, treats minor injuries and incision areas with antibiotic gel, and is aided through their operation with different kinds of serum which can be injected to aid in certain operations. Several operations have Stiles working to destroy strains of an artificial virus called GUILT in boss battle-style operations. While several strains return from the first game, new variants also appear which require different procedures.
While multiple operation types are carried over from Trauma Center: Under the Knife, different operations such as skin grafts and bone repair are included from later entries in the series. As with earlier entries, Stiles can use his Healing Touch to slow time for a short period, allowing him to treat wounds at a rapid speed. The operation is failed if the time limit runs out, or the patient's health drops to zero. After each surgery, the player is ranked on their performance, with the highest grade being "Super Surgeon". Once the game is completed, a new difficulty and challenge missions are unlocked for the player.
Synopsis
The game is set three years after the events of Under the Knife when Doctor Derek Stiles of Caduceus eradicated a man-made disease called GUILT created by the Delphi terrorist group. Stiles and his nurse Angie Thompson provide aid to the war-ravaged African nation of Costigar, befriending local doctor Adel Tulba. During his time there, Stiles must use the Healing Touch for the first time in years. After this, Stiles and Angie are recalled to Caduceus to treat a new GUILT-related disease called Post-GUILT Syndrome (PGS), a series of critical conditions that affect any patients with past GUILT exposure. A reformed Delphi appears to spread GUILT strains, determined to fulfill the original Delphi's goals. Caduceus are aided in their efforts against GUILT and PGS by two other medical research organizations, Acropolis Pharmaceuticals and the Hands of Asclepius (HOA).