Trauma Center: Under The Knife - Atlus
Copyright 2005 Alex You (GameFAQs)

v 0.99

Table of Contents:

A. The Game: What is it? [tcq]
B. The Menu              [tcm]
C. General Controls      [tcc]
D. Game Walkthrough      [tgw]
E. Credits               [tcs]
F. Updates/Contributions [tcu]
G. Copyright             [tgc]


-The Game: What is it?-

Trauma Center: Under the Knife is a game based off surgery. It shares some
similarities with the Operation! game.

The story goes like this: Basically, you (Derek Stiles) are a surgeon at
Hope Hospital in Los Angeles, California. You perform surgery on people,
people thank you for saving their lives, blahblahblah.

During the operations, you will have ten different tools (well, 11
technically, but I'm not gonna get into that) at your disposal.

There are several things you should watch out for during the operation:

Vitals (located in a heart on the top-left of the touch screen)- Basically,
the health of the person that you are operating on. If they reach zero, game
over, man! Game over! Vitals will normally drop down during most
times of operation. Vitals will drop faster if you leave disease-ridden
parts on the patient/patient's organs, leave things bleeding, cutting with
the scapel unnecessarily, etc.

Time Limit- A time limit. When this time limit runs out, most of the time
the operation will end and you will get the "Game Over" screen. Some levels
do not have a time limit, but rather have you focusing on certain other

Miss Limit- A limit to how many mistakes you can make. Mistakes are
basically if you misplace something or if you draw a line wrong. I find it
odd, though, that scalpelling a yellow dot incorrectly will net you a miss,
but scalpelling over the rest of the patient's body will just reduce their
vitals. O_o

At the end of your operation, you will get graded on your technique during
the operation. The three categories are:

Time Bonus: How much time you have left after the operation. The standard
time limit for most missions is about 5 minutes.

Vital Bonus: How many vitals you have left at the end, and how well you
managed their vitals. For instance, keeping a guy at 25 vitals all the time
better than having him drop to 1-5 and then at the end, restoring them back
up to, say, 50.

Special Bonus: This includes many parts of an operation that will be
specific to that operation. However, If I'm right, miss limits also count
in this area.


-The Menu-

Trauma Center's menu is composed of three options:

|New Game| Start a new game. You will have three save slots to choose from.

|Load Game| Continue a previous game from one of three slots.

|Challenge| Replay any operation that you have successfully completed. You
can earn better grades in this section if you wish.


-General Controls-

+: Select an Option
A: Confirm
B: Go back (if applicable)
X: None
Y: None
L: None
R: None
Start: None
Select: None
Touch Screen: Select and Confirm

Ingame (before and after operations)-
+: None
A: Next
B: None
X: None
Y: None
L: None
R: None
Start: None
Select: Skip through all text
Touch Screen: Next

+: None
A: Next (text)
B: None
X: None
Y: None
L: None
R: None
Start: Pause
Select: Skip through all text
Touch Screen:

OK, this is the meat of the game. On the touch screen, you have ten different
tools to choose from:

Laser- Used for burning off certain things. Can cause damage to vitals if
used incorrectly for too long.

Antibiotic Gel- Used for healing small wounds, stopping bleeding, settling
membranes in, and to restore ample amounts of vitals.

Drain- Used to suck certain liquids/small solids up.

Forceps- Used to remove foreign objects from a patient or to insert
something onto the patient. If you are taking something out, a tray will
appear on the bottom-right. If you are inserting something, a tray with the
necessary item will appear on the bottom-left.

Hand- Used for rubbing in membranes and reviving a heart. Perhaps one of
the least used tools in the game.

[slight spoiler]

Healing Touch (tap the Hand icon 2x after learning it)- Use it to draw an
imaginary star after you learn it. After you draw it, time will slow down
for a period of time based on how well you drew the star. You can only use
this once a mission.

[end slight spoiler]

Scanner- Sends out ultrasound waves to find objects such as tumors
underneath the surface of an organ.

Magnifier (will be in place of scanner when necessary)- Magnifies certain
areas of the body. I have no idea why they even made this. To magnify draw
a circle around the area you wish to magnify. I find drawing a C instead of
an O works better and more often.

Scalpel: Used to incise (cut) certain parts of the body. Will cause a drop
in vitals if held down or moved over unneccessary parts of the body.

Syringe: Used to inject certain medications. For each mission there will be
a stabilizer liquid and an injection needed for that mission. YOU WILL NEED
possible you may need to use it 20x or more in one operation.

Stitches: Used to close up wounds/large cuts. It is sometimes somewhat
annoying when trying to suture up large openings.

Bandages: Used to cover up stiched openings at the very end of an operation.

Each one of these items has a certain amount of times it can be used. This
is shown by a tiny bar on the box showing the tool. As it goes down the
tool will change color. When you completely exhaust it it becomes
unavailable for a few seconds.

Other things on the screen:

Vitals- The health of the patient. Displayed in the heart on the upper-left.

Electrocardiogram Reading- Shows the heartbeat of the patient (vitals).
Extends from the vital heart to the right.

Call- Use to proceed to the next text on the top screen. This is used only
when someone is talking to you. You may also use the A Button if you wish.

The top screen:

Time limit- Shows how much time you have remaining in the operation.

Miss limit- Shows how many more mistakes you are allowed to make.

Operation Score- Shows the points you've gotten from operating.

Text Box (bottom)- Brings up important pieces of info from the surgeons
during the operation.


-Game Walkthrough-

This is a list of every mission in the game (except 7 X Missions you can
get from completing the game).

[Kudos to Hitoshi for giving me this list]

#1 Standard Procedure          [gwa]
#2 Standard Procedure 2        [gwb]
#3 A Farewell                  [gwc]
#4 Singing The Blues           [gwd]
#5 A Real Doctor               [gwe]
#6 Life or Death*              [gwf]
#7 Dormant Ability             [gwg]
#8 Striving for Asclepius      [gwh]
#9 Awakening*                  [gwi]
#10 Just Let Me Die            [gwj]
#11 Please Let Me Live         [gwk]
#12 For Everyones Sake         [gwl]
#13 GUILT                      [gwm]
#14 Something Precious         [gwn]
#15 An Explosive Patient*      [gwo]
#16 Miracle at 9,800 ft        [gwp]
#17 Forbidden Knowledge*       [gwq]
#18 Race for the Cure          [gwr]
#19 Stepping Up                [gws]
#20 Taking a First Step        [gwt]
#21 Medical Research           [gwu]
#22 The Next Step              [gwv]
#23 New Laser Technology*      [gww]
#24 Doctors Struggle           [gwx]
#25 Under the Knife*           [gwy]
#26 Shifting GUILT*            [gwz]
#27 GUILT Evolves              [gw0]
#28 Infection*                 [gw1]
#29 Devil                      [gw2]
#30 Death Awaits All*          [gw3]
#31 First Sin*                 [gw4]
#32 Second Sin                 [gw5]
#33 Third Sin*                 [gw6]
#34 Fourth Sin                 [gw7]
#35 Fifth Sin                  [gw8]
#36 Sixth Sin                  [gw9]
#37 Final Sin*                 [gw=]
#38 The X Missions*            [gxm]

*stars indicate commonly asked for missions that I've seen.

General Procedure              [gpa]
General Procedure Tips         [gpb]


Standard Procedure

Fairly simple. Just follow the nurse's instructions and you'll do fine.

Basically, the operation is about removing foreign objects, healing small
cuts, opening areas on the body, suturing, and bandaging.


Standard Procedure 2

Once again, if you follow the nurse's instructions, you win.

Treatment of a tumor, pretty simple. First, use the ultrasound on the
top-right. Locate the tumor in the stomach. It should be between the
bottom-left and the bottom. Once it stays completely black, slice down the
middle of it with the scalpel. Cytoplasm will ooze out. Use the drain to
suck the fluids out, slice around the tumor, remove it with the forceps,
apply the membrane onto the bleeding area, apply gel, and rub it in. You win!


A Farewell

Inflamation treatment and multiple tumors. You should do fine on this, but
it is definitely possible to fail if you don't keep track of your vitals.
First, use the syringe and drain the blue liquid out of the bottle. Then
inject it into the little white dots. After that, locate the tumors
(I believe there are two), and apply the membranes. All done! Just keep
track of your vitals. If they get low (around 30 should be a warning)
use the green liquid in the syringe menu to restore vitals.


Singing the Blues

Polyps forming in the pharnyx. EASY (for me, at least).

Start by cutting open the person's (insert whatever you call that part).
After that, you will notice a bleeding area. Use the magnifier (if you're
having trouble, try a C shape instead of an O shape) to zoom in on the
bloody area. Drain the blood, and laser the polyps. They will start
bleeding again. You will have to drain the blood again and apply gel to the
small holes. If you want to you can smear gel over every single polyp and
burn as many off. This way the gel will automatically heal the little holes.
Do this until you get all of the polyps out, then zoom out. Whoops! More
blood! (But seriously, why didn't it come out until now? Or at least show
a sign or two...) Zoom in, get rid of them all, zoom out. Whoops! Even more
blood! Repeat the process until you have gotten rid of all the bloody
areas. Watch your vitals, as bleeding can cause quite a bit of damage if
left alone.

On a side note (not that any of you care) this was my first A rank!


A Real Doctor

This is the first mission most people start complaining about. Or at least,
it was the first one I failed! >.> Anyways, start by opening up the patient.
using the blue liquid. After you get rid of them RESTORE YOUR VITALS with the
green syringe liquid. Find all four (yes, four) tumors and get rid of them.
After you get rid of them, Angie will want you to ultrasound around the area.
Just check each place, and you will be able to suture the wound.


Life or Death

This is definitely THE complained about mission in the first chapter.
Anyways, you will first notice that this guy's vitals are at 01. Apply gel
to the moving bar area and move the hand along the black bar. Vitals will
go up to 30. Keep in mind that what makes this mission a pain in the ***
is that 30 is his max vitals. Apply gel to the smaller cuts, and pull out
the glass. Anyways, you might think you are done, but you aren't. Cut along
the line to gain access to his heart. HOLY CRAP GLASS IN HEART. MAKE SURE
YOUR VITALS ARE MAXED OUT AT 30. Anyway, start removing the glass, being very
careful not to make a mistake. Use the green syringe as necessary. After you
remove all the pieces of glass, uh-oh! Here comes the friggin' huge shard!
Remove it, being very careful to make sure it is fully pulled out, stop the
bleeding with the gel, and suture it. Now, the heart will completely rip
open, and his vitals will drop to 05. However, you will notice Mr. Pretty
Star thingy that will show up on the screen. You will have time to either
give him vitals or attempt to suture the wound immediately. It may take a
few tries to suture the rip. After you do suture it, though, his vitals
immediately go up to 30. Now, close him up, gel the stitch, and kill him by
forgetting how to put a bandage on. >.>


Dormant Ability

A unique mission that you won't have to do again in the game. Anyways (do I
use that word too often?) open up the patient. In the veins, you will have
to do the following to locate one of the thrombi: Ultrasound it until it
stays visible, forcep it (just touch it), scalpel it, drain it, and use gel.
Keep doing this until you've removed all of them. More of them come, but
luckily, Mr. Pretty Star comes along and makes the thrombi move extremely
slow. Do the same thing until the operation ends. END OF STORY.

Update: A strategy from Yuria Tayde:

"I only lost this stage once because all the moving peices intimidated me 
and I froze, when actually it isn't as hard as it looks. Now I play it 
again for fun! A trick is to Double up on the thrombi, scan several of 
them, pinch pinch, slash slash, drain drain, splash gel all over the 
place, and repeat. I managed to keep almost every one of them back with 
this trick, especially after using HT."


Striving for Asclepius

Omigod, I don't want to write this section, but I have to. Anyway, draw Mr.
Pretty Star (now known as the Healing Touch) as accurately as possible.
Depending on how accurately you draw them you'll get a different rank.
If you can't get an A on this... *sigh*



DEAR GOD I HATE THIS MISSION. This is by far THE most difficult mission in
Chapter 2. Going on (hey, I didn't use anyways!), when you open this guy up
you will see a little vein with a red dot on it. Use the brown sedative
liquid in the syringe menu to reduce the size of the aneurism. Next,
scalpel around it, and remove it. Drain the blood, use the forceps to join
the vessels, and make one little mark down the center of the vein with the
stitches. Now you've got more to deal with. If you need to zoom out and
then zoom back in so you can more accurately scalpel aneurisms. Next, more
aneurisms. From now they have a moderate risk of rupturing. If they do drain
the blood and keep going from there. Finally, 5 friggin' aneurisms. Barely
magnifiable at the same time. Geez, that sucks. Use the Healing Touch if you
want, and start using the sedative on the  aneurisms. If you simply scalpel
the aneurism but don't remove it it will stay there and won't bleed, so you
can focus on cutting more of them. It is also a somewhat evil but working
strategy to simply let them all rupture, keeping vitals high at the same
time. Remove all the aneurisms, end of story. Now wasn't that fun? *pats on

Update: A strategy from Yuria Tayde states:

"This stage pwned me for hours until I realised the same strat you use,
but I also improved upon it! In the 2nd section when all 5 appear: it IS
indeed possable to magnifie all of them, even though the ones at the top
won't have much space for your suction. They appear in a ring shape,
zoom in at the center. Inject the anti-inflamatory into all of them (I go
clockwise) until all 5 are small, then slice the last one you injected. Then
inject the remaining 4 as they'll be growing again, and repeat until all of
them are sliced. Then you can take your time removing and mending the blood
Letting them explode does crazy damage to the patient, I wouldn't recomend
it to anyone."

I would have to agree. I would not recommend letting the anuerisms rupture
unless you truly are desperate. If you do decide on this, don't let them
rupture all at one time.


Just Let Me Die

Fairly easy. Notice when you enter Linda's lungs, there are six lacerations,
three of which are extremely large. First suture the smaller ones, and then
drain the blood on the large ones, forcep the edges together, and suture it
like a small wound. You might think there's more but that's really it. Just
make sure vitals stay high.


Please Let Me Live

Oh, so Ms. Suicide Girl has a wittle change of heart, eh? Either way, you
will see the same cuts. Go ahead and suture them as done last time. Now
notice that one of your objectives was to find out what was the cause of
these lacerations. You're about to find out. After suturing all the
lacerations, you will notice a creepy music change and a laceration formed
on it's own. Use ultrasound to discover a little creature actually inside
her lungs. *shudder* Darn, I'm glad we don't have those in our world.
Ultrasound it so you can see it (like a tumor), scalpel it out, and
incinerate it with the laser. Keep in mind that the little fishy thing will
make more lacerations if you don't attend to it immediately. Kill it off by
using the laser to incinerate it. Anyway, after killing it, more will
appear. You can try to fish them out with the ultrasound and scalpel, or
you can focus on stopping the bleeding from the lacerations. However, DO
NOT suture every single laceration, or else the little things will start
making more of them. Next, after killing all of them, suture all but one
laceration, and fully restore your vitals. Suture the last one, and then
you get three huge lacerations in the shape of an astertik. Fish him out
using the ultrasound, laser it, tend to a few of the lacerations, and keep
doing until over. Suture all the lacerations, bring vitals up, and close
Linda up.


For Everyone's Sake

W00t, the type of surgery we'd expect from a game like this! Quite honestly,
though, it's very easy. Start by opening up her chest. You can see her
heart. Gel the yellow line and then... the electrocardiogram goes crazy and
her heart rate flatlines. Use the gel and massage technique to get her
vitals up, and open up the atrium. Drain the blood, and quickly scalpel the
right side, the left side, and then the whole thing. If you work fast you
can remove it before it starts bleeding. Around this time she may suffer
another flatline. Keep in mind if you do anything while her heart goes
crazy she will take some damage and you will incur a miss. Drain the blood
again, take the synthetic valve, suture it, close the atrium, close her
chest. Done and done.



Yay, you're at Caduceus. Now all you have to do is pass this little test and
you get in. OK, just do the same thing you did with Linda. DONE.


Something Precious

Yay, you only have to do this one two times in the storyline. Here's the
deal with Deftera. It's basically a moving tumor (yeah, I know it's
technically not accurate, shut up). They will leave behind tumors that are
black or white. Incinerate them with the laser, the larger ones first. When
they fuse, start draining. When you've drained them enough, they will start
to swirl and you will be able to scalpel it out. Be warned, as they swirl,
massive amounts of tumors will be created. Immediately remove the Deftera,
incinerate the tumors. You would be done, but remember that SECOND glowing
red dot on the wire frame? Guess what that means! Go on and suture the first
opening, and cut open the second. You'll notice two pairs of Deftera. Now
this part can get plain annoying. When two of the same color Deftera collide
they will create massive amounts of tumors. Also, if two start to fuse, but
another one crashes into it, they will stop fusing and leave some tumors
behind. Antibiotic gel can be used as a wall to block out the Deftera. If
you want to, you can start making one pair fuse, and then keep circling gel
around that pair so they keep fusing. However, gel excites them, which
means they won't fuse as fast if you do block them off. Once you get rid of
one pair, immediately destroy all the tumors. At this point Amy will
probably be fighting for her life, so restore her vitals as much as
possible. Get rid of the last pair of Deftera, close her up, and apply
the bandage. Done!

Side Note: This level has been known to glitch up a bit, along with any other
Deftera missions. Sometimes, you will end up with 2.5 or 3 pairs of
Deftera. If you have 3 pairs you can still complete the operation
(but it might freeze), but if you have 2.5 you will have to restart.


An Explosive Patient

Ladies and gentlemen, introducing... a time bomb! Yes, you have to operate
on a time bomb. Isn't that fun? When you start you'll be in this funky
little apparatus thing. Zoom in on the two water tanks on the right. Pull
out water from the right tank (but don't suck it over the top or you'll lose
water, which is bad). TAP the stylus on the other tank, and draw it down
from there. After this, there are several paths you can take. Go down to
the bottom-left dynamite sticks. Start pulling out the yellow detonators as
directed. However, on the second one, the dynamite will start to activate.
You can use gel to cool down the dynamite (the temperature is shown by the
rising yellow bar), however you do not have enough gel to keep all five down.
Keep in mind once the rods are removed the water no longer needs to
be monitored, so by going back you will waste crucial time. Now, I've only
done this one way, so I'll tell you myway. Probably another one of the FAQs
on GameFAQs has another strategy.After pulling out all six detonators, I 
immediately found my way to thechips at the top. From there, you must burn 
off the chips as told by Dr. Myers. Burn off the chips connected to the Heat
Sensors, but NOT the bombs (you figure out what happens). Look ahead if you
want the exact chips, if you want to figure it out, skip ahead.

*Gameplay spoilers ahead*

The chips are arranged as follows:
      _______   _______   _______   _______
     |       | |       | |       | |       |
     |   1   | |   2   | |   3   | |   4   |
     |_______| |_______| |_______| |_______|
 _______   _______   _______   _______   _______
|       | |       | |       | |       | |       |
|   5   | |   6   | |   7   | |   8   | |   9   |
|_______| |_______| |_______| |_______| |_______|
Burn off 3,4,5,7, and 8.

*end gameplay spoilers*

OK, after you burnt all the chips off, you're done... NOT! You will have 15
seconds to cut every one of the red wires. Be precise, make sure your DS is
properly oriented, and most important, STAY CALM. After this, you're done.
Fun, no?

Note that you can use HT on this level if desired, but I personally find
you don't need it.

Thanks to Yuria Tayde for pointing out that the chips connected to the
heat sensors should be burnt out and the proceeding strategy, that the water
doesn't need to be monitored after the rods are pulled out, and that there
isn't enough gel to keep the heat sensors completely cooled.


Miracle at 9,800 Feet

This mission is a lot like removing tumors, just in a different way. First,
perform a lobectomy, and you will see the lungs. Use the ultrasound as
directed to find a small black spot. Remember the tumor operation? First,
slice the black spot open. Some liquid will come out, and you'll need to
drain it. Once done close it up with antibiotic gel. There are 10 of these
spots to find. Once you are halfway done Angie will notify you of that. Now,
what makes this mission even a little bit hard (it's really not that hard) is
that you will have to work through turbulence. What happens is kind of like
the electrocardiogram in For Everyone's Sake. The plane will start shaking
a little bit. At this time you should make a few adjustments, but cease
operations after about 5 seconds. When the plane starts rapidly shaking,
do not do anything or you will poke a hole in the lungs, reduce the vitals,
and incur a miss. If any of the liquid is exposed during turbulence I believe
an inflammation will form. Just inject the anti-inflammitory liquid into
the inflammation.


Forbidden Knowledge

Yay, third GUILT strand you will encounter. Note that this level can easily
change direction depending on how you play it.

Start by opening up Reuben. You will see all of these triangles and thorns.
Welcome to Triti! This level can easily be defined as a puzzle. First,
the leader of Caduceus Europe will tell you to scalpel the thorns out.
Just grap the forceps, since Angie will say to use the Forceps no matter
what tool you choose. Start removing the thorns. When you remove three thorns
from a triangle, you will see the incision dots. When you remove it, you will
notice that more triangles grew. So, how to counter this?

There are two basic rules on Triti regeneration:

A. If a triangle has two thorns on an exposed edge, a new triangle will grow
off of it when a triangle is removed.

B. If a triangle is left alone and has at least one thorn, new triangles will
grow on each side of it.

So, when removing each triangle, make sure there aren't too many exposed
edges. To stall regeneration you may want to work from the bottom-right
to the top-left, since the triangles will stop growing once they reach
the end of the pancreas. Now, each time the group of triangles flashes,
Reuben's vitals will drop (I believe it is .33 damage each time per triangle,
rounded up). If you find a purple triangle, each time it flashes, it will
cause massive damage to the vitals. Take it out as soon as possible, but
don't leave sides exposed just to take out the purple one. Finally, don't
drop a triangle or it will grow a thorn and regenerate as shown in Rule B.


Race for the Cure

This mission is very easy. First, you will notice that you have five
potential locations. You need to gather three types of Tetartri fluid.
Obviously, there are two of one type, two of another, and one of the last.
I got lucky and found all three on my first three attempts, though. During
the operation, you will notice little puffs of toxins coming from whatever
organ you are operating on. Use ultrasound to locate a little creature
that looks like a jellyfish. Cut it out like a tumor, and use the serum
to try and stop it. Once you use the serum it will head under the organ
again. Just fish it out and keep injecting the serum until it is dead.
Then move it onto the tray, cut it open, and use the drain to suck out
the internal fluids. Done and done.


Stepping Up

OK, this mission can be a pain if you are even a little bit colorblind.
Remember the Tetartri from the last mission? Now you have to differentiate
colors. First, you will notice poison diverticula. Inject the correct color
serum into the correct diverticula. Incise it, but don't remove it. Work
on the other diverticula. Once you have incised all of the diverticula,
remove them and apply the membranes. Note that if you let one grow to the
fullest size, it will release poison that you will need to stop with
the gel. Once all three little spots are gone, the tetartri will show up.
There is one yellow, one green, and one blue Tetartri. You have to inject
the correct color serum into the correct Tetartri. GO FOR A YELLOW OR GREEN
ONE FIRST. The blue one is very easy to figure out, but it is easy to forget
which tetartri is yellow and which one is green. Also, the gases they leave
behind correspond to the color they represent. Once again, blue is easy
to distinguish, but yellow and green may be a little hard. DO NOT INJECT
THE WRONG SERUM. If you do more diverticula will form, and this can be a real
big pain. Once you've injected the serum into all three the process will
repeat. Later, they will move faster and retreat quicker. If they retreat you
will have to re-inject the serum to all three of them to cause damage.
Healing Touch can help around stages 3 or 4. After this, you are done.
Simple enough.


Taking a First Step

The first of a five-stage series on a new type of GUILT. Anyway, incise the
skin. Welcome to Pempti! This GUILT is basically a gelatinous substance
with a core that can replicate itself many times. OK, first, just do as
Victor says. Use the laser, scalpel, and antibiotic gel as told. Next is the
colored serum part. You have four serums. First use the one on the right on
the small concentration of pempti cells. It looks like a big white fungus
moving around in the gelatinous substance. Then use the one on the mid-right,
then the one on the mid-left, and finally the one on the left. Keep in mind
that after you use the one on the mid-left each time the Pempti hits against
the body you lose one vital. Just something to keep track of. Now, just
alternate between medicines as told by Victor. First, the right one,
then the middle-left one, then the middle-right one, and finally the
neutralizer on the left. Now just cut the cells out. That's actually all
there is to the mission, but as I said, it's part of a five-stage series.

Side note: If you must inject the stabilizer, make sure you do not inject it
into the Pempti fluids or else you will incur a miss and lose some vitals.


Medical Research

Complete a puzzle. You don't have a time limit, but you still only have
a limited amount of time to use the forceps, so don't hold on to a piece
for longer than you need. Note that the puzzle never changes, so in Challenge
mode, just remember the position of the pieces, and quickly put them in
place. DONE.

*do not read ahead if you want to figure out the puzzle on your own*

The solution looks something like:

  .   .
R   R   O
  R   O
G   W   O
  R   W
G   B   W
  G   W

.- Blank
R- Red Piece Sections
O- Orange Piece Sections
G- L. Green Piece Sections
W- White Piece Sections

(kind of hard to illustrate, just attempt to read as best as you can.)
*end gameplay spoilers here*


The Next Step

You've made a new nanomachine, YAAY. Next, you have to perform another
experiment on Pempti. Cut the patient open, and you will be back at the
Pempti liquid. Inject the nanomachine (handily located at the syringe
menu) into the concentration of cells. Once it's at the lowest it can be
you'll see something appear and the entire substance will reform. Luckily
you don't have to do much after that, so once again, fairly easy mission.


New Laser Technology

Complete a puzzle. See Medical Research.

*puzzle solutions ahead*

Puzzle 1:

  R   R   B
W   R   P   B
  W   R   .
W   R   P   B
  .   P   P
W   G   O   O
  G   G   O

Puzzle 2:

  Y   Y   B
G   Y   B   O
  G   Y   B
G   Y   R   O
  P   .   O
P   P   R   O
  P   R   R

R-Red Piece Sections
O-Orange Piece Sections
G-Green Piece Sections
W-White Piece Sections
P-Purple Piece Sections
B-Blue Piece Sections
Y-Yellow Piece Sections
*end gameplay spoilers*


The final stage of the Pempti encounter. Unfortunately, this is fairly
difficult at the beginning. First, inject the nanomachine like in
The Next Step. Once the fluids are at the lowest you will see something
that looks like an eyeball appear. Start to zap it with the laser. However,
it will start to produce smaller eyeballs. Zap those immediately, because if
you don't, they will make quick lacerations that you will have to suture,
wasting time. If it releases all five at once, start zapping them (you should
be able to get two). It will release the fluids temporarily, and any columns
in which there were the eyeballs will have tumors in them, which you will
have to burn off with the laser and use the antibiotic gel to close them.
Keep zapping the eyeball with the laser until it dies. It's a fairly simple
concept made difficult by constant distractions.


Under the Knife

Now where have we heard that before? ;-) Anyways, don't panic when you see
the objective. It says you have to operate on 5 patients in 10 minutes or
less. However you only have to be operating on the third patient when time
runs out to win. Anyway, it's basically the same thing with the Kyriaki.
However, this time, a small Kyriaki will also be found with the large one.
Later, as you progress onto more patients, there will be more Kyriaki in each
stage of removal. Don't use your HT until at least the third patient.


Shifting Guilt

Remember the triangles? Same rules apply, except now thorns will get 
vaporized very commonly. If they vaporize you must drain the poison before 
it escapes. However I believe if you let it go on the first patient you get
an easier second patient, and if you let it go on the second patient you get
the easiest third patinet. However, if you let gas escape on the third
patient, game over. So, basically, it's the same, except there are more 
Triti to deal with. You can try to use an HT at the beginning and pull out 
all the thorns, but it's a lot harder than previously because of the fact
that the thorns vaporize. Keep track of your vitals as well,
because purple triangles will regenerate even if you pull it off.


Guilt Evolves

Tetartri mission! Again, it's the same thing as the last Tetartri mission
(Dr. Kasal). Go for the yellow or green diverticula first, the yellow or
green Tetartri first. Make sure you don't mismatch colors, or else you
will have more diverticula to deal with. The only real difference is that
the Tetartri will be very hard to deal with at the end.



Hooray, it's Dr. Myers! Anyways, open up her body, and suture the cuts on
her small intestine. Then, you will see some sort of worm come out. Welcome
to Paraskevi! This can really be a pain if you don't know what you do or you
act really recklessly. First, laser the worm's tail. Then slice it with the
scalpel. OMG UNICELLULAR. It will split in two and cause lacerations. You
must keep cutting the worms until it is small enough to extract. Keep in mind
the worm itself will not cause any damage. I believe you must reduce the
Paraskevi to 1/16 of it's original size to extract it. That means, you will
to deal with 2+2*2+2*4+2*8 lacerations, or 30 lacerations. So ,if the worm
will not cause any damage, what makes the mission hard? As you go on, you
will find that some of the worms will start escaping. After you've extracted
as many worms as possible and let the rest escape, you will have some time to
suture the lacerations. Suture all but one, restore the vitals to maximum,
and suture the last one. There are four stages. You will remember that Victor
says that if it reached her heart, she's a goner, right? That means the
fourth stage, is obviously the heart. There's a little space on the fourth
stage to hopefully extract the rest of the Paraskevi if you haven't already,
but if you need to cut more on the last stage, more than likely one of the
Paraskevi will fly into her heart. If even one Paraskevi at it's smallest
size enters her heart, GAME OVER. So, the obvious way to avoid this is to 
stop the worms earlier in the operation. I suggest using the stages like
1. Cut up as many worms as possible, extract one or two.
2. Use the HT, extract as many worms as possible.
3. Extract any remaining Paraskevi.

If you do it correct you won't get to the fourth stage. Also, if you aren't
sure if you'll be able to extract a Paraskevi because it is too large, don't
extract it. If you attempt to it will cause lacerations, but if you just let
it go, it will just start moving again. Also, be sure to suture the
lacerations as you go along, or they will cause too much damage. Gel stops
the bleeding, so use that while you suture the lacerations. This is a mission
that you WILL have to use the green stabilizer.

Updates: I have received a lot of information regarding strategies to beating
this level. Here are some tips:

From Jewl:

"About the Infection mission, with the Paraskevi, I actually found it easier
to go about cutting the worms the same way I dealt with rocks in asteroids,
number control.  Only cut 1 of every 2 worms it splits into, until you can
remove them.  What makes it even easier is the bigger the worms are, the
longer they stay frozen with the lazer.  Basically just keep the bigger
ones frozen whil you work on the littler ones, until they're all gone. 
Makes damage control from the lacerations a lot easier, and while a couple
smaller worms will escape to the second level, they aren't difficult to
take care of, even without using a healing touch."

From Yuria Tayde:

"Keep all worms stunned at all times, if one isn't stunned, stop what you're
doing and lazer it again. If the patient is stable, cut one (only 1) of the
worms; the smallest one you can find. You'll slowly work your way through
their ranks this way, and the lower numbers make it much easier to keep them
from getting away. Letting them all go so you can stabalize the patient
should be a last resort, but it gives you all the time you need sence they
won't continue towards the heart until you chase them. 
(furthermore, cutting them all causes ALOT of cuts, meening you'll need to
stabalize more often while at the same time handling a higher number of
much faster worms! My strat just requires less skill to win.)"

Agreed with both contributions.



OK, this mission can be easy if you just know what you're up against. First,
open up the guy's body, and you'll see lacerations. First, suture them up,
but leave two. Restore vitals, and suture the second-to-last one. Immediately
grab the laser and get ready. Some little spiders will crawl out of the
laceration. Welcome to Savato! Luckily this is a very premature and
undeveloped form. Start to zap them, and close up the laceration. More
lacerations will appear, followed by more bugs. Be warned, when the bugs
start to circle around, there is nothing you can do to kill them. Just kill
off remaining bugs. After a little bit of time, the circling bugs will
combine into one big blue bug, which reduces your vitals by half and lowers
the maximum vitals. Try to kill the blue one if possible. Just keep killing
the spiders and suturing the wounds until the Chiral readings are negative.


Death Awaits All

OK, first, notice that you have 10 minutes to complete this mission. You will
think,"That's a lot of time!", but if it's your first time, it's really not.
I can almost assure you you will fail the first time. Second, you cannot use
the Healing Touch in this mission due to factors later. Aside from that, open
up his chest, and you'll see this spider on his heart, along with a web. Try
to laser him. He'll move around super-fast. There is nothing you can do about
this yet. Grab your scalpel and start slicing on the webs. When you slice one
your scalpel will melt for a little bit. Just wait until it regenerates, and
then cut more. Occassionally Savato will create a new line of web along with
some bugs that you don't have to immediately take care of, but I recommend
you get rid of them as soon as possible. Occassionally the web will start
to turn red. If this happens, DO NOT LET THE WEB TURN COMPLETELY RED. If you
do your vitals will drop by 30, no matter what. To avoid this, just cut
one strand of the web. The web will revert to white, giving you more time.
There are several stages in which you will have to cut the webs, it's either
three or four. Once you have cut all the webs Savato won't make any more.
From here all you have to do is keep lasering Savato. However, using the
laser speeds him up for a bit, and if you make him speed up too much, a
laceration with bugs will be created. Also, occassionally, he will make a
circle of lacerations somewhat shaped like the petals on a flower. When you
laser him enough (you'll know when you have) use the scalpel on him. Victor
will arrive with a serum that you'll have to inject. However you will have to
reduce Savato's shield again with the laser. After you laser him enough and
scalpel him, inject the serum. You will see a Healing Touch activate. Savato
will proceed to go crazy and make lots of lacerations. You'll find that if
you try to inject the serum he'll just move out of the way, and lasering or
trying to do anything to him will fail. Remember how I told you not to use
the Healing Touch until a certain time? Now is the time. Use the HT, and
note how time stops. Yes, stops. And since nothing can move when time stops
except for the person who initiated the stop, guess what you have to do?
Inject the serum into Savato. The lacerations will heal, vitals will go up,
and Savato will explode. Close him up, and kill him by scalpeling "LOL" in
his chest. That'll feel GREEAT.

Update: To clear up some confusions, you need to use your own Healing Touch
ON TOP of the automatically-initiated one.


First Sin

Hooray, Kyriaki archeotype. Basically, it's just the same thing. However,
the Kyriaki now take a long time to incinerate, and many more will come
during the stages. Try to use the gel on the lacerations before adding
the stabilizer, as that will reduce the bleeding. If you are having trouble
controlling the laser, it's better just to TAP a Kyriaki with the laser
than to hold the laser on it. If you hold it you will most likely burn
a hole in the small intestine, which can be a pain if you have many more
lacerations. A good first priority is simply locating every Kyriaki, cutting
all of them out, and THEN incinerate all of them by tapping them quickly
in succession.

If you're good at Kyriaki this should not be a problem.

Also, this is a small section contributed by Kelvin Tay (see credits):

"Take your time to fix up the lacerations, and just before you suture the
final one, ensure the patient has max hp. Get ready for the GUILT; quickly
suture up the 2 new lacerations, then switch to ultrasound to locate the
Kyriaki bodies.  Quickly incise both of them ASAP before attending to
anything else. Once both are exposed, fix up the many, many lacerations they
caused whilst injecting serum and lasering the Kyriaki in short bursts (to
prevent them from creating more tears).  You'll have to alternate between
these 3 steps real quick, and you'll most likely only manage hp at 50-60.
Once you've defeated 1 of em, quickly prepare to incise the new Kyriaki.
Repeated the 3 step alternation. Once all 4 are defeated (ensure max hp at
this stage with no tears, before you finish of the last 1!) the boss will
appear.  Quickly get the healing touch going, locate and expose the Kyriaki,
then use the 3-step method of lasering in short bursts, healing with shots,
and stitching the cuts. After some time you'll complete this super fast-paced
challenge, which will illustrate how far you've developed as a virtual
surgeon.  At this point you may want to consider getting a degree in
surgical medicine lol!"


Second Sin

Deftera archeotype. Basically, just do the same thing as you did with Amy.
However, this time there is more potential for the tumors to wreak havok
in the second stage than the first time. Just control the tumors, and focus
on draining one of the pairs of Deftera out of the two in the second stage.
Once you do that the mission is cake.


Third Sin

Triti Archeotype. First, you will notice that there are three "main" bodies
of Triti. I used an HT, and pulled out the bottom-left body of Triti first.
After this you will be left with a HUGE section of Triti, but it's easy
to counter if you can efficiently work on Triti. Just start from the bottom
and work up. Take off single rows of the Triti at a time, watching out for
gas. The mist can form new membranes elsewhere, so be careful. Also, if the
thorns appear to grow back too fast, make sure ALL of them grow back (it is
easy to miss a thorn, messing up your plan), and then start removing them.

weapon2000 of GameFAQs contributes this tip:

"First off, pull out the left-most body of Triti. Then, start at the bottom
and work your way up. Use HT at the last row, finish it off."


Fourth Sin

Tetartri Archeotype. It's really not hard or different at all. Just use the
previous methods described ([gws] or [gw0]). The only difference is that now
you have a smaller place to work with (about half the normal size), so it
is now easier for the Tetartri to overlap, which in turn makes it easier
to misplace an injection.


Fifth Sin

Pempti Archeotype. Currently, I have not completed this level, but here
are some tips from other players:

typezero (edited for spelling):

"I just wanted to tell you what happens in the 5th Sin is the Pempti. The
beginning is easy, but gets alot harder after you zap the core a couple
times. It is crazy fast and if you haven't got to this level already, when
the core spits out those 5 smaller cores and then forms those collumns, if 
you don' ttake them out fast enough the core will make them again and the 
collumns will form again, and will kill the tumors which will cause bleeding. 
I couldn't get past this now, but i think after 6 or 8 zaps the level will

Dan K.:

"Pempti is a huge pain in the *** to deal with. Basically I have a few tips:
Make sure the patient is at max Vitals before you lazer the main core. After
that happens, you need to do your best to laser away the little cores that
come out. The lacerations are a pain, but quick to fix. Also, when the small
tumors appear, take them out right away. I save time by dousing the area in
gel and quickly lasering them so it repairs the hole right away.  When the
core makes the 5 mini cores spin around it, just hold the laser down over
the outside of it to quickly destroy them. There is no real strategy to this
GUILT, just timing."


Sixth Sin

I haven't completed it, but here's a tip from Dan K.:

"Paraskevi is not any more difficult then it was before. My strategy
was to cut it down as much as possible, not worrying about extracting
the pieces of it until they are ready to go. If you slice them up as much
as you can, then take time to heal the patient, you should be able to get
rid of some of them by the second to last stage, and enough will be left
for you to HT and remove in the heart chamber."


Final Sin

Obviously, I haven't done it, but another tip from Dan K.:

"Savato is again, a pain in the ass. First off, as strange as this may
Keep slicing the webs and use the syrum to raise the vitals. I tried
keeping up with the bugs, but there will just be too many to deal with
as the level progresses. When the bugs go into it (there are varying
rounds of how many times you have to slice the web), dont laser it yet.
Heal the max vitals, then laser it in short bursts. This doesnt
completely preven the lacerations from forming, but slows it down.
Attack the bugs and suture the lacerations right away when they are
formed, administering the vital syrum as needed. When the shield is
gone, attack with scalpel. The second and third times are strange. This
GUILT reacts more powerfully as the Vitals of the patient rise. Keep him
around or under 50 at all times, and the it won't give you near as much
trouble as it will if it max out. If it starts spinning and makes 3
lacerations over and over again, suture as fast as possible and heal.
Repeat until the third time. After this the operation is pretty much
over. Inject it, it goes crazy, wait for the HT to auto activate, then
use yours, inject again. Game over. You won."

[gxm] The X Missions

OK, these are the extra missions you gain after you beat the last chapter.
First, be warned, THESE ARE NOT PUSHOVERS. If you have tons of stress from
trying to beat the game, good luck finishing these.

And second, the X Missions each involve a particular type of GUILT, just
likethe Sinner missions did. Finishing one will unlock the next (X1 unlocks
X2, X4 to X5, etc.).

X1: Kyriaki

Haven't completed it, but here's a helpful tip from Dan K.:

"If you are a total and complete expert on the Kyriaki strain, this will
still be almost too much for you. I haven't beaten it yet, but can at least
warn you what to exepect. They don't wait for you to finish suturing the
initial wounds before they appear, usually abour 40 seconds into the
operation. Also, THREE of them appear initially, and they slice almost
continuously before and after they are exposed. That is hard enough. And the
next batch won't wait for you to finish the first batch, again slicing fast
and over and over again. I haven't gotten more than 1:30 into the mission
yet. Good luck!"

X2-X7: No info available.

---End Game Walkthrough


-General Procedure-

This section contains how to successfully complete an objective. It only
shows things that take more than one menu (IE no suturing wounds).
Interferences may or may not be included.

Small Foreign Object Removal- Forceps, Remove Object, Antibiotic Gel.
Large Foreign Object Removal- Forceps, Remove Object, Stitches.
Removing a Tumor- Ultrasound, Scalpel, Drain, Scalpel, Forceps, Remove,
Forceps, Apply Membrane, Antibiotic Gel, Hand.
Inflammation- Syringe, Blue Anti-Inflammatory Liquid, Release Syringe into
Polyps- Laser, Drain, Gel.
Cardiac Revival- Gel the Box, Move Hand along moving bar.
Thrombi- Ultrasound, Forceps, Scalpel, Drain, Gel.
Aneurisms- Syringe, Brown Sedative, Release Syringe into aneurism, Scalpel,
Forceps, Move aneurism into tray, Drain, Forceps, Place vein together,
Suture Large Wounds- Drain, Forceps, pull wound together, Stitches.
Heart Valve Replacement- Scalpel x3, Forceps, Move heart valve to tray,
take synthetic valve, move synthetic valve to artery, suture.
Edera- Ultrasound, scalpel


Note: Effects of GUILT (like tumors from the Deftera) are not covered
in this section. This only shows how to defeat a GUILT.

Kyriaki- Ultrasound, Scalpel, Laser.
Large Kyriaki- (Ultrasound, Scalpel, Laser)<--Repeat as necessary
Deftera- (Wait until fusion, drain)<--Repeat as necessary, scalpel,
forceps, move Deftera fusion onto tray
Triti- (Forcep, pull out thorns as necessary, scalpel, forceps, move triangle
to tray)<--Repeat as necessary
Infant Tetartri- (Ultrasound, scalpel, syringe, serum)<--repeat as necessary,
forceps, move tetartri to tray
Tetartri- (Syringe, corresponding serum, release syringe into corresponding
Tetartri)<--Repeat as necessary
Pempti- Nanomachine x3, laser.
Paraskevi- (Laser, scalpel, laser, forceps, remove if it is small enough to
tray)<--Repeat as necessary
Stage 1 (web):
Stage 2 (non-web):
(Laser)<--Repeat as necessary, scalpel, Syringe, Serum, Release Syringe on
Stage 3 (Auto HT):
Healing Touch, Syringe, Serum, Release Syringe on Savato


-General Procedure Tips-

This section shows how to more effectively follow procedures

Small Foreign Object Removal- Spread antibiotic gel immediately before
removal. The gel will immediately cover the cut after you place the glass
on the tray.

Large Foreign Object Removal- Spread the gel immediately before removal. The
gel will slow down the bleeding. After doing so spread some more gel to
further forristal bleeding and proceed to do whatever you need to do.

Removing a Tumor- If there are multiple tumors, just cut off the tumors,
but don't excise them. After you drain all the tumors then remove all
of them, apply all the membranes, apply the gel, and use the hand.

Inflammation- Well, just get rid of it as soon as possible. Nothing big.

Polyps- Spread gel over polyps immediately before using the laser. The polyps
will automatically heal and you won't have any blood left over.

Cardiac Revival- Use the gel, because it makes the process faster. Thanks
to NiCk Is tEh RoXX0r for reminding me to put this here.

Thrombi- Don't worry about if the Thrombi pass through. Just focus on taking
each out one by one. It does minimal damge if it passes through.

Aneurisms- Incise the aneurism, but don't remove it. This way you will have
more time to work on other aneurisms before they burst.

Heart Valve Replacement- Nothing big. Just work fast, and don't work
while the heart goes crazy.

Edera- Find about two or three sections of liquid at a time. At this rate you
should be able to gain good progress before turbulence hits.

GUILT (some info might be outdated, for more info, look in a corresponding
mission in the walkthrough)

Kyriaki- Locate every Kyriaki within an organ before attempting to incinerate
it. After doing so, grab the laser and TAP, I repeat, TAP, the laser on
the Kyriaki. It's the exact same as holding the laser. Just tap the laser
on each of the Kyriaki in quick succession. Also, when suturing lacerations,
use the gel and syringe combination to increase vitals fast.

Deftera- Coming soon.

Triti- If you don't mind getting a very low rank, start with an HT. On the
more advance levels, pull out about half of the thorns, and start scalpelling
away. More than likely a lot of thorns are going to vaporize, so you won't
have enough time to pull all of the thorns out. Then scribble over the
yellow dots with the scalpel and pull them out.

Also, if you are left with about two or three Triti, and thorns keep growing
back before you can remove the triangles, let all of the thorns grow back,
THEN remove them. This way they will all grow back over the same period of
time than every one or two seconds.

Summary: Don't rush, make sure you can tell what you are doing and where
it's going. If you just back it up into a corner then you should do fine.
Also, remember to pump the stabilizer in at a good rate. On any triti
mission, you can do fine to HT at the very beginning and pull about half
of the triangles out.

Tetartri- I'd highly suggest, as emphasized in the Tetartri sections of the
FAQ, to avoid the diverticula as much as possible, as that can just be a
pain. Other than that, work fast, and definitely look for the yellow
or green Tetartri first.

Pempti- Coming Soon.

Paraskevi- Coming Soon.

Savato- Coming Soon.



Hotashi, for supplying me with the names of all the missions when I lent out
my game.

??? (, for reminding me that Shifting Guilt is a Triti

Kelvin Tay (, for contributing a section to the First
Sin mission.

Tony Tran (typezero), for contributing a tip on 5th sin.

Jewl, for contributing a tip on Paraskevi.

NiCk Is tEh RoXX0r, for reminding me that using antibiotic gel with
cardiac revival speeds up the process.

Yuria Tayde, for contributing many tips on certain missions, such as
Dormant Ability (gwg), Awakening (gwi), An Explosive Patient (gwo),
Triti in general, and Paraskevi in general.

Dan Kegerreis, for contributing many tips on the last few sinner missions
and the first X mission, thus completing the main walkthrough.

weapon2000, for giving an alternate Third Sin strategy.

GameFAQs, for letting me put this on their site.

Atlus, for making such a challenging yet fun game.

You, for buying this game so that this guide wouldn't be obsolete.



If you notice a mistake in my guide (which most likely there is one or two),
please notify me about it. If you wish to contribute something to my FAQ,
please tell me what it is as well.


Or, attempt to notify me on the GameFAQs boards. My username is GlowingSword. 


Copyright?2005 Alex You. This may be not be reproduced under any
circumstances except for personal, private use. It may not be placed on any
web site or otherwise distributed publicly without advance written
permission. Use of this guide on any other web site or as a part of any
public display is strictly prohibited, and a violation of copyright.