Surgery

This page is a part of the TGMC wiki. TGMC is a project based on the CM-SS13 codebase.

While most injures can be treated using cryogenics, chemicals, and your standard tools, certain injuries will require surgery to heal.

For important information about general treatment and identifying injuries, see Guide to Medicine. For information on reviving dead bodies, see Guide to Defibrillation.

The Basics of Surgery

Identify any needed surgeries

If your patient is alive, they will likely be able to tell you what is wrong with them. If they are incapacitated or unsure, a health scanner or body scanner will be able to tell you what is wrong with them.

Important injures to look out for:

• Implanted Alien Embryo - Highest priority, as you will only have a few minutes to perform Foreign Object Removal before the patient bursts. Take care of this first, and if the patient begins to shake and scream you may need to kill them and perform the surgery before reviving them.
• Infection and Necrosis - Infections require administering Spaceacillin, which may advance to necrosis if left unchecked. To fix necrosis, perform Necrosis Treatment before the limb is completely rotted.
• Missing Limbs - Perform Limb Replacement surgery on the missing limb. For a missing arm and hand (or a missing leg and foot), you will only need to replace the arm (or leg). Use a bioprinter to print biotic limbs for human patients and robotic limbs for robotic patients. Marines can not be fixed if decapitated, but the synth can be fixed with Head Reattachment.
• Organ Damage - Pills can be used to cure any damage to the brain, eyes, and ears but Organ Repair surgery will be required for chest organs such as lungs, heart, liver, as well as the kidneys in the groin.

Most other wounds can be healed using other methods, though an experienced surgeon may be the quickest way to repair broken bones.

Prepare for surgery

You will first need to find a surgical room to bring your patient to. Look for an operating table and be sure to ask someone if you cannot find it.

Directions for use:

• Before use, ensure table has an anesthetic tank loaded. Clicking a table with a tank will place it in if there isn't one already.
  • You can also add a blood pack to the operating table. When a patient is on the bed, they are automatically connected to the blood supply.
  • To remove the anesthetic tank or blood pack, right click on the bed with an empty hand and select the relevant item.
• Grab patient, then click the table to place them onto it.
• Click-drag patient's sprite onto the table to connect them to the anesthetic system.

Once your patient is on the surgical table, look for a surgical tray. If you do not see one nearby, use your ID to check the nearby locker.

Next, Wash your hands at a sink. Surgery causes infections so you will need to wash your hands to prevent it from being worse. If you are in the field or can not find a sink, soap or cleaning spray can be used on yourself instead.

After that, give your patient a spaceacillin pill or injection to further prevent infection.

Perform the surgery

Using the tools in your surgical tray, perform whichever surgeries are required. The Visual Guide below as well as the List of Surgeries both provide information about how to use the tools needed and perform the surgeries.

Be sure to target the specific body part your surgery needs to be performed on. Attempting brain surgery on a person's leg wont work!

Some surgeries can be performed while doing others to save time, keep these in mind.

If you forget which step of surgery you are on, using a scalpel and cautery in both hands at the same time will cancel the surgery.

If you have done everything correctly, your patient should be healthy and ready for discharge. Do a final check with the operating table's built-in body scanner to make sure you did not miss any injuries. It can be accessed by right clicking the operating table with an open hand and selecting the analyze vitalsbutton.

Visual Guide

SURGERY START

Fractures

Internal Bleeding

Necrosis

Larva

Organ Damage

Limb Replacement

SURGERY ENDS

Surgeries

Operation:	Steps:
Foreign Object Removal (Everywhere except mouth/eyes.) (Alien embryos will be in chest)	Optional for shrapnel. Use tweezers to remove shrapnels. Make an incision. or -> -> Open the ribcage for embryos. -> Pull out any unwanted crap until it's all gone. Close the ribcage if needed. -> Close the incision.
Bone Repair Surgery (Everywhere except mouth/eyes.)	Make an incision. or -> -> Repair the bone. -> Close the incision.
Limb Replacement (Limbs.)	Target specific limb on the bottom right targeting doll. Seal the stump. or -> -> Print a new limb using a bioprinter. Use biotic limbs for humans. Slap a new limb on. Arms fit for hands, and legs fit for feet.
Internal Bleeding (Everywhere except mouth/eyes.)	Make an incision. or -> -> Mend the artery. Close the incision.
Organ Repair (Groin/Chest. Excludes eyes/brain.) (Chest contains heart, lungs, liver) (Groin contains kidneys)	Make an incision. or -> -> Open the ribcage if needed. -> Fix up the organ with a surgical membrane. Close the ribcage if needed. -> Close the incision.
Wound Repair (Everywhere except mouth/eyes.)	Cannot be performed if the patient has an open surgical incision. Suture the wounds closed. Repeat if necessary.
Necrosis Treatment (Wherever it appears.)	Make an incision. or -> -> Cut out necrotic tissue as needed. -> Close the incision.
Brain Damage (Head.)	Having alkysine makes this surgery defunct. Use first, if possible. Make an incision. or -> -> Open the skull. -> Repair heavy brain damage, if applicable. Pull out embedded bone chips until they're gone. Close the skull. -> Close the incision.
Eye Repair (Eyes.)	Using imidazoline is faster than surgery, if you have it on hand. Fix the eyes. -> -> Cauterize it.
Amputation (Head/Limbs.)	Cut through the limb/head with a saw. That's it.
Facial Reconstruction (Mouth.)	This is a cosmetic surgery. If someone shows as Unknown (as), it'll restore it to normal. Fix the fucked up face. -> -> Cauterize it.
Head Reattachment (Head.)	This is only applicable to decapitated synths. Prepare the neck for reattachment. or -> -> -> Attach the head and then defibrillate.

Combining Surgeries

Name:	Icon:	Why:
Fix-O-Vein		Can be applied at any point during an operation to fix Internal Bleeding.
Organ Repair and Foreign Body Extraction	+	Can be performed at the same time in the Head, Chest, and Groin.

Surgery Equipment

Equipment:	Use:	Horrible Alternative:	Success Chance:
Scalpel	Professional knife for cutting flesh.	Kitchen knife	75 %.
Retractor	Salad tongs used for rearranging and moving internals.	Crowbar	75 %.
Hemostat	Pulls out foreign objects, and stops scalpel bleeds.	Wirecutter	75 %.
Cautery	Cauterizes incisions closed.	Cigarette	75 %.
Bone Saw	A saw used to saw apart bones.	Hatchet	75 %.
Incision Management System	Cuts, retracts, and clamps bleeders for an incision
Bone Gel	Gel used to repair broken bones	Screwdriver	75 %.
Bone Setter	Sets bones back into their original place.	Wrench	75 %.
Fix-O-Vein	Fixes veins and arteries.	Cable Coil	75 %.
Surgical Membrane	Patches up any damage to the organs, excluding the brain and eyes.	Bandages	20 %.
Surgical Suture	Can be used to heal brute and burn damage.	Glass Shards	20 %.

Organ Damage

Organ damage is based on stages, with the default being stage 0 when organs are healthy, stage 1 when organs are bruised at 10 damage, and stage 2 when organs are broken at 30 damage.

Alkysine and Imidazoline can be used to heal brain and eye damage respectively. Peridaxon Plus can be used to heal all organ damage, but organ repair surgery may be needed to fix organs if peri is unavailable.

Damaged organs will passively cause pain at a rate of 1.5 pain per damage.

Name:	Icon:	Damaged Penalty
Brain		Reduces all skills by 1 per stage.
Eyes		Causes blurriness when bruised and blindness when broken.
Heart		Reduces max stamina by 25 per stage and max health by 20 per stage
Lungs		Reduces stamina regen by 40% per stage and applies 1 slowdown per stage.
Liver		Lowers the threshold for toxin dealing passive organ damage by 20 per stage and spreads the damage to other organs when broken. Passively heals itself when toxin damage is low and is not bruised or broken. Purges toxins but takes 0.3 toxin per stage when doing so, with slower purging per stage. Heals 0.1 toxin every second, reduced by 0.1 per stage. Chance to vomit every second, 1% per stage.
Kidneys		Reduces amount of chems you can handle at once before getting druggy by 1 per stage (default is 6) and increases probability that overflow causes confusion by 10% per stage (default is 10%) as well as increasing this confusion duration by 2 seconds per stage.
Appendix		Only the passive pain

Field Surgery

Certain situations may call for field surgery outside of medbay, likely with limited resources and improper facilities. With proper preparation, even corpsmen with limited medical skill can pull the larva out of the FC groundside.

Field surgery is an advanced skill. If you are not comfortable doing surgery steps without looking them up, you should practice those before attempting it. Longer surgery means more bloodloss.

The Basics of Field Surgery

Failure chance and infections will be the two biggest threats while performing field surgery. Minimizing the risk of both will be the difference between healthy patients and patients with 3 necrotic limbs.

Medical Doctors, Chief Medical Doctor, Synths, and Medical Researchers all have higher surgery skill, making field surgery easier as them. Corpsmen can still do field surgery too, but will require more preparation to do it successfully.

The first thing to find will be a surface to perform surgery on. Surgical tables are ideal, but rollerbeds will likely be what you have access to. Regular tables can also be used, but will have a higher failure chance.

Putting patients to sleep

• Awake patients will increase failure chance drastically. Ask them to sleep (and hope you are fast enough to finish before they wake up) or bring soporific or chloral hydrate to knock them out. Soporific lasts longer but acts slower, while chloral hydrate is fact acting and metabolizes faster.
• Mixing both using 3 or 4u chloral and 11 or 12u soporific should knock people out instantly then keep them knocked out for a while. A mix of chloral hydrate and polyhexanide can also be used, but will not last as long.
• To wake them up early, use dylovene, water, or hypervene.

Managing Infections

Germs are the biggest threat when doing field surgery. If you do not properly prepare, you may be leaving your patients with worse injuries than you had fixed.

• Use soap on yourself to reset your own germ count. Failing to do so will transfer germs on every surgical step.
• Administer spaceacillin for lower germ counts or polyhexanide for higher germ counts.
• Surgical and gas masks all reduce germ transfer. Dont do surgery without one!
• Gloves will reduce germ transfer, while latex gloves reduce it even more.

Other Tips

• The surgical webbing can hold all surgery tools at once, as well as tweezers. Use it for field surgery!
• Both the Tadpole and APC can be equipped with surgical tables to enable safer field surgery. Coordinate with your team to get an ambulance setup going!
• Soap and cleaning spray can both be used instead of a sink to clean your hands.
• Wound Repair Surgery is the quickest way to fix a body that has large (>500) amounts of damage. As the drill is only needed for less useful surgeries, you may benefit from carrying a second Surgical Suture instead to hand to a nearby corpsman so that both of you can do Wound Repair at the same time.