As you ready yourself to step into the operating room, you catch a glimpse of your reflection in the mirror. With a fishbowl on your head and a patient’s gown barely covering your backside, you’re not exactly the picture of a sophisticated doctor. Not only do you look like the fashion equivalent of chucking clothes into a blender, but you’ve got some pretty poor motor control, lifting scalpels and surgical hammers with a claw-like grip. What poor sod’s life depends on you?

That “poor sod” is Bob, the patient you’ve operated on countless times before, replacing his arms, legs, ribs, and head on numerous occasions. The only guidance you have comes from a disembodied voice on a loudspeaker, providing you with instructions in a way that is totally not mysterious or reminiscent of a blood-soaked Portal 2. Pay it no mind - you’re a doctor, damn it, and you’re here to operate, not speculate.

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Surgeon Simulator 2  overhead view of surgery

After running around the lab solving puzzles and gaining access to the body parts and tools you’ll need, you’re finally ready to start the surgery. This time it’s a simple arm transplant, but instead of slowly sawing Bob’s arm off to keep his blood loss to a minimum, you’ve learnt that it’s quicker to simply rip his arm from its socket like a piece of morbid Lego and deal with the consequences later.

As Bob rapidly starts to bleed out, you lunge for a blood-stopping syringe, accidentally grabbing the tomahawk you stupidly didn’t move before the operation began. Rookie mistake. You fling the tomahawk aside with some impressive throwing chops (seriously, you should consider that as a career when this surgeon thing inevitably fails) and manage to use the syringe to save Bob’s life before it’s too late.

It doesn’t matter though - the syringe goes into Bob, but Surgeon Simulator 2 bugs out, has a tantrum and doesn’t register it, leaving our hapless guinea pig to bleed to death. This is all part of the fun so you smile and restart, noting to move the tomahawk next time. After completing the same puzzles in the same space and wondering whether you really need puzzles in your surgeon simulator, you get ready to operate again. History repeats itself and you lose another Bob, making you question who the joke is really supposed to be on.

This mixture of peaks and valleys sums up much of my experience with Surgeon Simulator 2. I went into the sequel with high hopes, as I have fond memories of the first game and its skill-based chaos. Sure, you were using a fire extinguisher to break ribs, but you also had to figure out where to slice, what to break, and what goes where to complete each mission. With the sequel, that sense of logical satisfaction is nowhere to be found.

surgeon simulator 2 side profile of ongoing operation

Surgeon Simulator 2 is a very different beast from the original game, and focuses more on narrative, puzzles, and its multiplayer component. It’s like the difference between ostomy and ectomy - sure, they sound the same, but in reality, they’re very different things. You’ll still spend some time doing surgery, but the mechanics are toned down and far less engaging.

One big reason for this is that Surgeon Simulator 2 ditches the fixed position of the original and gives you full control over your would-be doctor. This means that surgery is much more approximate than precise this time around, and you can generally get away with jabbing at an organ and pulling at it, rather than carefully making incisions or trying to pull out specific teeth with the utmost care.

On paper, I’m fine with Surgeon Simulator 2 taking a different approach to gameplay and leaning into the inherent wackiness of it all, but I don’t think the new direction works. Having a narrative is a novel idea, but it never pulled me in despite a decent sense of humour and some admittedly fun twists.

The original game’s signature joke had to do with how you’d perform laughably precise tasks with deliberately wonky inputs, exemplified further by the fact you could directly control each of your fingers to pick up tools, pluck organs, and cause chaos. The sequel only gives you the ability to point, grab, and twist your hands, which works well mechanically, but means the once-beloved aspects of clumsiness are almost entirely absent. Now when you can’t grab something, it feels more like a lack of control rather than a lack of mastery over control. I couldn’t be patient and improve - it just didn’t feel good to play.

Surgeon Simulator 2 catching bobs head in surgery

Instead of mastering wonky hands and surgical tools, Surgeon Simulator 2’s gameplay is largely focused on puzzles. Each level tasks you with navigating your way to the surgical table by finding fuses to open doors, ripping down vents, and hitting buttons. These puzzles aren’t necessarily bad, but they take away from the main reason you’d probably want to play a game called Surgeon Simulator in the first place.

Toning down the original’s mechanics may initially seem necessary for facilitating cooperative play this time around, but it also leaves the game with a lack of replay value. There’s no real drive to revisit the game because the surgeries themselves are so easy - the only challenge comes from finding equipment and moving through the hospital, which feels more like Handyman Simulator or Walk Through Rooms Simulator. Combine that with a short runtime and I felt like I was done with Surgeon Simulator 2 before it even had the chance to start.

I can imagine playing Surgeon Simulator 2 with your friends is a lot more enjoyable than playing on your own and probably negates some of the more tedious elements of the game. As a billy-no-mates, I did it all on my own. Still, even though I’m sure that’s not the right way to play, I can’t help feeling that bringing a friend along wouldn’t have redeemed the bland puzzles and simple surgeries either.

When Surgeon Simulator 2 focuses on the surgeries and your own skill as a player, it’s a lot of fun, but it feels like it often avoids that in an effort to become an entirely different type of game. Less vent exploration, more intricate teeth surgeries next time.

Surgeon Simulator 2 Review Card

Surgeon Simulator 2 is available on Xbox One, Xbox Series, and PC. We tested the Xbox Series X version for this review. Review code was provided by the publisher.

Surgeon Simulator 2

Surgeon Simulator 2 offers even more physics-based mayhem, including co-op multilayer for up to four players, a story mode from the pen of Tomb Raider scribe Rhianna Pratchett, and a bunch competitive challenges. 

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