X Operations Guide by NickOfTime

Version: 1.3 | Updated: 08/31/07 | Printable Version

|                  Ver. 1.3                 |
|  By NickOfTime (NickOfTime146@gmail.com)  |
|  Copyright 2007 by Nicholas Carrasquillo. |

| Legal Notice |

The only sites allowed to host this guide are:


Please don't take it without my permission.

This guide is actually fully intended to only be hosted on GameFAQs, mostly
because it uses the "Triti Guide (GIF)" as a minor supplement. Just letting you
know ahead of time so you don't feel bad when I decline your offer. Except on
certain occasions.

| Contact Info |

If you wish to contact me, my e-mail is NickOfTime146@gmail.com. However, if
you're going to ask me a question that is answered here, don't e-mail me. If I
get back to you when you e-mail me something like that, it'll probably be
something very mean. :|

Contact me if you have a new strategy for a certain X operation, as this will
aid those who view this guide. I will give full credit to those who contact me
with new strategies, as long as they provide a name. Or I'll just use the name
I got as an e-mail address (except for the @email.com part; so, using my e-mail
address as an example, "NickOfTime146@gmail.com" would be credited as just

Also, have the subject of the e-mail be something like "Trauma Center X
operations guide" and I'll know that you have something to say about it.

| Introduction |

Since I heard about the trouble people have been having on the 7 X missions in
Trauma Center, I figured I might make a topic about it. But after realizing
that the topic won't last for quite a long time due to topic purging, I decided
to write a guide that I could submit, so it'd be able to help longer. 

This guide is here to provide tips and/or help you figure out how to complete
every last X operation. If you still need help on a certain part or are unclear
as to what you should do at a certain part, email me and I'll try to get back
to you. Really. Unless you could get help by just re-reading it.

Also, since this is a guide on Trauma Center, there is going to be some
spoilers, obviously.  Just letting you know.

Despite the spoilers, however, this guide is written on the basis that you
know some things about the game. Like where the tools are, how to use them, who
everyone (including Adam) is, and basically how to get rid of each GUILT. I
mean, you got to the X operations, so you must know how to get rid of them,

Anyway, no one really reads this stuff, so on with the guide.

| Table of Contents |

1. General Tips
2. X Operations "Story"
3. X Operations
  3.1. X1: Kyriaki
  3.2. X2: Deftera
  3.3. X3: Triti
  3.4. X4: Tetarti
  3.5. X5: Pempti
  3.6. X6: Paraskevi
  3.7. X7: Savato
4. Version History
5. Credits
6. Copyright Information
7. Conclusion

Just Ctrl+F and find what you're looking for.

| 1. General Tips |

If you just started on these X operations, one easy thing to do is learn how to
use two styli. It helped me finish nearly all of them easier, and it'll help
with getting higher ranks on them.

If you want to learn how to use two styli, try doing simpler operations with
both of them, using your left hand to pick out the tools on the left, and using
your right hand to get things done and pick out the tools on the right. Or vice
versa, if you're left-handed. After a while, you could try doing things with
your left hand, like cutting open a patient or suturing. 

Just know that it'll be a bit easier to get the operations done with two styli.
It's definitely possible with one, but it probably might take a little longer.

| 2. X Operations "Story" |

I put "story" in quotes because of the fact that there's pretty much no story.
The only reason these operations exist is to give you that extra challenge you
crave so much. However, there is that little bit of dialogue between Stiles and
Adam that some people would consider a small bit of "story." So I'll include
that bit of info. Look for it in the "X# operations" sections; it'll be there.

Also, the people you're operating on remain completely anonymous. You don't
even know if the person's really alive, dead, boy, girl, young, old, or
anything like that. I just assume that the person you're working on is Adam
himself, even though the patient in X6 looks like a woman.

| 3. X Operations |

Adam will have three bits of dialogue that are consistent throughout all the X
operations, save for X7. I just thought I'd include them here.

During the operation:
Adam: "No matter how hard you try, you cannot overcome the power of death!"

After completing the operation (except for X7):
Adam: "Your skills have given birth to many lives which never should have been.
       ...They are your GUILT..."

When the patient dies:
Adam: "People strive toward death... Only a fool could deny that."

They all sound pretty villian-ish to me.

I'll also give you tips on if you should use the Healing Touch (abbreviated as
"HT"), and when you should use it.

-----| 3.1. X1: Kyriaki |

Time Limit: 5:00:00
Condition: Dr. Stiles's unreleased report number 1: Invisible blades "Kyriaki"

Adam: "This... is mankind's first sin. Man created swords to kill, and was in
       turn killed by swords. Don't you see? Man has always sought ways to
       achieve death."

Derek: "That's not true! We created many other things in order to live!"

First off, let me say that if you could finish this operation, you are able to
succesfully finish any other operation. It also might take you longer to read
this than actually do it. Just letting you know how incredibly complicated this
might seem. Even so, it's easy once you got the basic routine down.

After opening up the patient, you'll notice that there are four large gashes,
and three normal lacerations. The first thing you want to do is suture three of
those gashes and all of the normal lacerations. After doing that, raise vitals
to 99, and close up that last gash. This will cause the first wave of Kyriaki.

Use the Healing Touch right when they're making their appearing lacerations.
This will help you if you're just trying to complete it for the first time.
After using the HT, immediately ultrasound where they ended their lacerations
and cut them out. Right after that, apply antibiotic gel all over the lung in
a sort of "M" shape. This will prevent your patient's vitals from spiking down
too fast for you. 


I cannot stress this enough. Keeping the gel on the lacerations will prevent
vitals from dropping too fast for you.

To raise vitals when needed, just switch between the gel and stabilizer.

After remembering to do that, continue with incinerating the Kyriaki. Know that
after two of them disappear, the next wave shows up. So just destroy one, get
vitals up for the next wave, and destroy the other two at the same time. 

Don't try to suture anything yet. If you do, the Kyriaki will just recreate the
lacerations that you sutured. Besides, you're going to suture it all anyway.

Do the same thing with those two Kyriaki that you did with the first three.
Ultrasound, scalpel, gel (everywhere), stabilizer, laser, etc. If you had
success with the first three, these two will be no problem for you.

After destroying those two, suture everything (remember to keep gel on the 
lacerations still) except for one (1) laceration. Before suturing that last
one, raise vitals to 99. If you run out of stabilizer, don't worry about it.
If your vitals are close to 99 and you're almost out of stabilizer, use that
last bit so that you actually do run out. It'll fill back up faster.

After that, the mature (or "boss") Kyriaki appears, with one regular one. 
Repeat the same procedure as before, and you have it done. Congratulations.
You still need to keep the gel on the lacerations when you start treating the
last of the lacerations. 

That's it for X1. Not complicated, right?

-----| 3.2. X2: Deftera |

Time Limit: 5:00:00
Condition: Dr. Stiles's unreleased report number 2: Creeping tumors "Deftera"

Adam: "Man crawls on the earth like vermin, breeding and fighting for eternity.
       Yet you dare judge them... You who lost the will to die properly."

Derek: "What's that even supposed to mean!?"

Getting rid of the Deftera in the stomach is much too easy to give you tips on.
So I won't. I'll just skip right ahead to the Deftera in the lung.

However, don't bother to raise vitals when you're done with the stomach; vitals
are raised to 99 automatically.

At first glance, this operation seems like a walk in the park. Then the Deftera
start ramming into each other. Despite what happens, you shouldn't panic. That
usually ends up causing you to screw up. 

Also know that the gel acts as a temporary "wall" for the Deftera. Meaning that
if you apply gel somewhere, the Deftera won't go across it, and will just 
bounce off it. This is incredibly useful if used right.

Work only on draining one pair first, too. It's too much hassle to do both at
the same time. When one pair of Deftera stall on each other, apply gel in a 
circle around it. This will prevent the other Deftera from breaking it up and 
spiking vitals.

After draining a pair, you don't have to worry about the same colors of Deftera
ramming into each other. You still have to draw a gel circle to prevent a 
break-up, though.

Use the Healing Touch if you see that there's "too many" tumors and vitals are
getting low.

When you get rid of one pair, clean up the tumors with the laser, treat any of
the wounds you may (or may not) have caused, and then move on to the next pair.
Make sure that your vitals aren't too low.

That's it for X2. Whoo.

-----| 3.3. X3: Triti |

Time Limit: 5:00:00
Condition: Dr. Stile's unreleased report number 3: Contagious nightmare "Triti"

Adam: "In 1995, the Aum Shinri Kyo cult attacked a Tokyo subway station. We
       studied that attack in detail while developing our own GUILT. Their
       weapon was an airborne virus which calcified its victims' organs. ...But
       the public was lead to believe it was just sarin gas. Modern man is the
       very model of hypocrisy. You glorify the discovery of medicine, but hide
       the fact that your own kind is creating disease!"

Derek: "...And you'd rather create new ways for us to die? That's insane!"

I personally view this operation as a "love or hate" procedure. 

One way to do it is to use the HT right away, then take out as many thorns as
humanly possible, then take out as many Triti pieces as humanly possible. 
Repeat if necessary. 

Another way to do it is to use the pattern found in the "Triti Guide (GIF)" on 
the FAQ list for this game. I haven't used it right, but it seems helpful.

The easy, but long way is to take out the few Triti on the upper left, and
nothing else. This will cause the rest of the Triti to become this gigantic
mass, but it's easy to manage, since it won't really grow any bigger. To deal
with this giant petrification, systematically take out one layer of Triti at a
time. This means that you should take out the thorns that are on the upper
left, and take out the Triti that are exposed. The bottom right corner
shouldn't be worried about until the upper left is extracted.

Continue doing this until you have two (2) Triti pieces left. When you're at
this point, wait for the 4 thorns to regrow. Then take out all four at once,
cut it all, then take the Triti pieces out as fast as you can. If a thorn
vaporizes, then don't bother continuing. The other thorns will grow too fast
for you. Just wait for that thorn to regrow, and try again.

In general, if a thorn vaporizes, drain it. If you don't, it will trigger the
growth of more Triti in some other area.

If one Triti piece is left alone (no other adjacent pieces exist) and it has
a thorn, it will trigger the growth of more Triti.

You may use the Healing Touch for the last 2 or 3 pieces, unless you're fast
enough to get all of it before the thorns regrow.

That's it for X3. Not too hard.

-----| 3.4. X4: Tetarti |

Time Limit: 5:00:00
Condition: Dr. Stiles's unreleased report number 4: Synchronized poison

Adam: "Nature mandates that mankind will eventually succumb to its poison.
       However, humans created their own poison, called medicine. It's
       delusional to believe you can poison Nature to avoid your fate."

Derek: "No... It's delusional to dismiss people's deaths as "fate." "

This operation is most likely the easiest X operation there is. In fact, the
only tip I have to give you is to use the HT when you feel that they're going
too fast for you. 

But if you slip up and inject the wrong serum into the wrong Tetarti, all three
will reconstruct their diverticula. If this happens, it's no problem. Just
start the operation over. 

One more thing. For the starting diverticula, the bottom one is purple, the one
on the right is green, and the one on the left is yellow. This is good to know
so you won't have to wait for them to grow to inject the serum into them.

That's it for X4.

-----| 3.5. X5: Pempti |

Time Limit: 5:00:00
Condition: Dr. Stiles's unreleased report number 5: Armored bacteria "Pempti"

Adam: "Mankind's greed has no ending... You continue to consume everything
       until even your hose is laid waste. Is your survival that important?
       ...So important you would trade it for the earth's destruction?"

Derek: "If people as a whole are consuming too much, then maybe that's another
        disease we have to cure!"

This operation is slightly based on luck. The attacks that the core uses is
completely random after the initial laceration/tumor/revolving core attacks, so 
if you find yourself smothered by tumors or lacerations, you could just start
over and hope that you'll only get the revolving cores.

Here's something from the GFAQs boards:

"From Matt_Kamineko
Does anybody try the X missions with the pause-unpause technique?

I only got past Pempti by switching tools and targetting laceration nodes while

After reading this, I realized that Pempti could be dealt with a lot easier by
doing this. What it is: Before choosing a tool or positioning your laser on a
laceration/tumor/revolving core, you pause it. Then you position your stylus on
the core you're going to attack, or the tool you're going to select,then 
unpause and laser/select. This is an extremely useful technique, and will help 
you if you're trying to complete it for the first time.

If you're fast enough, however, keep the laser on the main core even if it's 
not active. Doing this will hit the small cores as they're sent out. It's a
small advantage, but with Pempti, you'll need every bit of it. 

Use the Healing Touch if you see that the Pempti's attacks are more extreme
than usual. This means it's nearly defeated. 

Again, this operation is slightly based on luck. If you wish to use the pause
technique, then go ahead.

That's it for X5.

-----| 3.6. X6: Paraskevi |

Time Limit: 5:00:00
Condition: Dr. Stiles's unreleased report number 6: Arrow to the heart

Adam: "In young forests at the dawn of time, plants were born with the ability
       to kill humans. ...Such simple, perfect beings. Do you understand the
       meaning of such toxic organisms? They demonstrate that all creation
       seeks an end to mankind."

Derek: "If humans are to be judged... it won't be at the hands of other men!"

As usual, the Paraskevi go through the body from the intestine to the stomach
to the liver, then to that little area under the heart that I can't identify.
Then it ends up digging into the heart and mutilating it.

Now, if you've done Sixth Sin and did a good job at it, you might just finish
this one without any trouble. However, the procedure in doing this is slightly

Due to the fact that every X operation gives you an incredibly unstable
patient, the lacerations that the Paraskevi make when you cut it in half must
be sutured as soon as possible. When you cut it in half the first time, you can
either keep freezing one half and work on the other, or let the other half go
on to the stomach so you could focus on worrying about only one. Either way 

After reading that, you may have figured out that you should only worry about
one Paraskevi section at a time. When you cut the half you're working on, start
working on one of those halves, and keep the other half frozen. Keep doing this
until you're able to extract the single sections of it.

Don't cut two Paraskevi sections at once. This will just cause your patient to
lose vitals unnecessarily quickly, and possibly kill him/her. Even if there's
two Paraskevi sections that only need to be cut one more time to extract, don't
do it.

If you haven't been able to contain the Paraskevi and you're close to the
heart, use the Healing Touch. You may also use it if you haven't been attending
to the lacerations, and vitals are dropping a little too fast.

That's it for X6.

-----| 3.7. X7: Savato |

Time Limit: 10:00:00
Condition: Dr. Stiles's unreleased report number 7: Faceoff with death "Savato"

Adam: "My beautiful, perfect image of Death itself...Savato. But... What if I
       told you this Death existed in all human DNA? ...I merely gave it the
       chance to take form. This is the Death you have denied. ...Our guide to
       the truth."

Derek: "Even if what you're saying is true, Savato remained dormant. We found a
        way to overcome Death-- that was humanity's choice!"

This operation is generally about having your priorities set. 

During the first "phase," Savato will have his little web, as usual. You'll
find out that this web is stronger than in Death Awaits All and Final Sin. But
don't worry. If you want to, you could just slowly scribble over the web, which
will weaken the strands. Then cut one strand, and raise vitals. When Savato
reconstructs a strand, cut that one instead of a weakened one.

Or, you could just ignore the fact that it's stronger, and do the same thing
you've been doing for the other two Savato operations. It's all the same.

When Savato spawns the little bugs, which I call Savatolings, you should only
worry about them if you have nothing better to do. Meaning that if you're
waiting for a scalpel, and the patient's vitals are high enough (99), then
laser them. I prefer to leave them there, because it's too much hassle to tend
to everything at once. 

When the Savatolings spawn a blue Savatoling, your vitals are instantly halved.
Most people tend to panic because it seems like the patient's going to die. 
Just raise vitals and continue if you're going to leave it there. 

If you see that a blue Savatoling is flashing red, you could laser it or not
worry about it. It won't do anything to hinder your vitals when it explodes
into a bunch of normal Savatolings, so do what you want with it.

Also know that only 3 blue Savatolings could exist at any time. This is why I
leave them there. Vitals could only be up to 35, but the web won't cause a
decrease that extreme.

How you should prioritize the first "phase" of Savato:
1) Cutting the web
2) Keeping vitals stable (I generally leave it at 40-50)
*) Lasering the Savatolings

(The * means it's entirely optional; it won't matter since they're going to
 disappear into Savato anyway)

During the second "phase," Savato will generally wander around until you get to
lasering him. But this is X7, so he'll generally wander around and randomly
make triple lacerations, causing vitals to drop by 15 with each attack. Unless
you laser his shell, of course. Also, don't worry too much about the
Savatolings. If you become distracted by them, Savato will kill your patient
because you left him unattended.

It seems like touching Savato with anything other than the laser will cause him
to go ahead and make those triple lacerations. So if you're in the middle of
suturing something, and he gets in the way, go all the way around him. You just
might get a Cool for it anyway.

Something from the GameFAQs boards caught my interest:

"From ultrafiremage
i saw a really nice tactic in a x7 video... the guy lasered, then sliced savato
and while it was stunned, he lasered the crap out of it and he was able to 
slice it again immediately.

i tried it and it only works twice in a row because the laser will delplete 
itself by then so use it on the last two cuts"

If you do this, there's only a small risk that Savato will ever get to use his
triple laceration attack. I've done it, and Savato never got to attack at all,
save for the mandatory Savatoling spawning. I'm sure this will help you.

How you should prioritize the second "phase" of Savato:
1) Lasering Savato
*) Lasering the Savatolings
*) Suturing the lacerations

After stabbing Savato the third time, the Savatolings will once again be
absorbed into Savato. This is when you come in with the black serum. When you
inject it into him, he'll make his usual nine-laceration attack.  This will
only make your vitals go down to 30, if it's higher than that. His
three-laceration attack after that doesn't do anything to your vitals, though.
But every attack after that does 25 vital damage. So use your second HT after
the first one activates and get rid of the thing.

All the lacerations will instantly become healed after Savato dies, but you're
free to suture all of them during your "time-freeze" HT. It lasts forever, so
feel free to take your time.

That's it for X7. 

Adam's dialogue after X7 is different than the rest.

Adam: "Your skills have given birth to many lives which never should have been.
       As it is written in Revelation 9:6, "During those days men will seek
       death, but will not find it-- they will long to die, but death will
       elude them." Just as the prophecy states, I have set a plague upon
       mankind to torment those who have betrayed natural law. ...At the end of
       all life, I alone will stand as an angel before the gaping abyss... I,
       who have become the great destroyer Apollyon! ...Your medicine is
       deceit, and you are nothing but a false prophet..."

| Version History |

-----| Version 1.0 |

The first version of the guide.

-----| Version 1.1 |

Added neoseeker.com to the list of websites authorized to host this guide.
Also touched up on some little details.

-----| Version 1.2 |

Fixed some more small details.

-----| Version 1.3 |

Fixed more details that were bothering me.

| Credits |

Credits go to:

Nintendo: For making such a great handheld console, the Nintendo DS.
Atlus: For making such a great game, Trauma Center: Under the Knife.
CJayC: For making this site, http://www.gamefaqs.com
Matt_Kamineko: For notifying me (and everyone else) of the "pause technique."
ultrafiremage: For notifying me (and everyone else) of the technique one can
               use to stab Savato twice in a row.
You: For reading this guide, of course.

| Copyright Information |

Trauma Center: Under the Knife is Copyright 2005-2007 by Atlus.
This guide is Copyright 2007 by Nicholas Carrasquillo.

Please do not take this guide and do something bad with it, or else. >:(

| Conclusion |

So there you go. If you're still reading this, then I know you have nothing
better to do with your time. Not that it's a bad thing of course. Free time is
usually a sign of wealth. Hopefully you've been helped by this guide. If you
haven't, constructive criticism is welcome. Any typos or mistakes you may find
are easily fixed if you notify me of them. Just don't send anything like "lol u
r nub i could do dat operation in dis way you nubhole." If you do, I'll block