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Trauma Center: Under the Knife

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Trauma Center: Under the Knife

Trauma Center: Under the Knife
Trauma Center: Second Opinion

North American cover of the original Nintendo DS release.

Developer(s) Atlus
Director(s) Kazuya Niinou (DS)
Daisuke Kanada (Wii)
Producer(s) Katsura Hashino
Hiroshi Kato (Wii)
Programmer(s) Nobuyoshi Miwa
Tomoaki Kasuya
Naoaki Hashimoto
Writer(s) Shogo Isogai
Composer(s) Kenichi Kikkawa
Shoji Meguro
Kenichi Tsuchiya
Series Trauma Center
Platform(s) Nintendo DS, Wii
Release date(s) Nintendo DS
  • JP June 30, 2005
  • NA October 4, 2005
  • EU April 28, 2006
  • NA November 19, 2006[1]
  • JP December 2, 2006
  • EU August 10, 2007[2]
  • AUS August 28, 2008[3]
Genre(s) Simulation, Visual novel
Mode(s) Single-player

Trauma Center: Under the Knife, known in Japan as Chōshittō Caduceus (超執刀 カドゥケウス Chōshittō Kadukeusu, lit. Super Surgical Operation: Caduceus), is a simulation game developed and published by Atlus for the Nintendo DS and is the first entry in the Trauma Center series. The game was released in Japan on June 30, 2005, in North America on October 4, 2005 and in Europe on April 28, 2006. An enhanced remake for the Wii, titled Trauma Center: Second Opinion (Caduceus Z: Futatsu no Chōshittō (カドゥケウスZ 2つの超執刀 Kadukeusu Zetto Futatsu no Chōshittō, lit. Caduceus Z: Two Super Surgical Operations) in Japan), was released on November 19, 2006 in North America, December 2, 2006 in Japan, and August 10, 2007 in Europe. The DS version was followed by a direct sequel, Trauma Center: Under the Knife 2, released in 2008.


  • Gameplay 1
    • Wii version 1.1
  • Plot 2
    • Under the Knife 2.1
    • Second Opinion 2.2
  • Reception 3
    • DS version 3.1
    • Wii version 3.2
  • References 4
  • External links 5


Trauma Center is a surgery simulation game with visual novel elements, in which players play as a rookie surgeon named Derek Stiles. The game is divided up into several chapters, many of which involve an operation that the player must clear in order to progress through the game. During each operation, the player will be tasked with completing the operation's objective within a time limit, whilst making sure to keep their patient vitals up. The operation will fail if the patient's vitals drop to zero, the time limit runs out, or a certain objective is failed. At the end of each operation, players are ranked based on their performance, such as speed and accuracy. Clearing the main story campaign can unlock additional challenge missions.

Gameplay is controlled on the Nintendo DS' touch screen using stylus controls, with players selecting from an array of surgical instruments, each with their own uses. These include standard tools such as scalpels, forceps, and sutures, antibiotic gel for disinfecting and healing small wounds, syringes for administering various types of medicine, ultrasound for finding hidden anomalies, a drain for removing excess blood, a laser for attacking small anomalies, and magnifying glasses for zooming in on certain areas. Each operation will feature various types of injuries and anomalies which each require the use of multiple instruments to treat. Early on in the game, the player gains the ability to perform the Healing Touch, which can be used once per operation to temporarily slow down time, allowing players to treat anomalies quickly in hectic situations.

Wii version

Trauma Center: Second Opinion builds upon the DS version with enhanced graphics, new controls, and additional content. Players use the Wii Remote to utilise each of the instruments, whilst the Nunchuk is used to quickly select instruments. A new instrument exclusive to the Wii version is the defibrillator, replacing the heart massage, which requires players to use both the Wii Remote and Nunchuk to resuscitate patients. Instruments are also streamlined, with some items such as bandages only appearing when necessary.

Second Opinion features an exclusive set of "Z-missions", which are gradually unlocked as the player progresses through the main campaign. During these missions, players play as another doctor, Nozomi Weaver, whose Healing Touch ability restores a patient's vitals with successful actions. These missions make additional use of the Wii's features, such as using gyroscopic controls to rotate bone fragments into place and position light sources in dark areas. Completing all of these missions, along with the main story campaign, unlocks an additional chapter featuring both doctors.


Under the Knife

Trauma Center is set in the year 2018, where medical technology has advanced such that effective treatments for previously incurable diseases, such as AIDS and cancer, are available.[4] The story is told to the player via dialogue between the characters, either presented in cutscenes or during operation.

The player assumes the role of Derek Stiles, a doctor at Hope Hospital. After the near-death of a patient due to his negligence, he encounters the scene of a car crash and ends up working on a patient with incredibly severe injuries to the heart. Just as it seems like the patient is done for, a power within Derek is unlocked, and miraculously saves the patient. The power emerges once more, and Derek saves another patient when a seemingly routine operation gets dangerously out of hand. His superiors recognize the ability. They tell him that his power is said to be that of a descendant of the Greek god of medicine, Asclepius, and his gift is known by the same name, though is more frequently referred to as the Healing Touch. He practices his use of the ability, though is left weakened after forcing the power to activate under his own will. After performing another operation, Derek blacks out for a short period of time. Dr. Kasal advises Derek to avoid using the ability due to the toll it takes on his body, and Director Hoffman tells him to outright turn his back on the ability, saying that the responsibility is too great for him to handle. After saving Linda Reid, a teen with a strange parasite (eventually known as Kyriaki), he learns of a new man made disease known as GUILT, which is distributed by a medical-terrorist organization known as Delphi.

It is at this point that Derek decides to embrace his ability and use it to end the threat of GUILT. He then begins working for Caduceus USA as their main surgeon, where he heals a young girl who has the second known strain of GUILT (Deftera). During a conference, Delphi sets a bomb with the intent of killing the doctors attending. However, with the help of Cybil Myers, he successfully defuses the bomb. After this, he flies to Africa to aid Caduceus Europe, and encounters the third strain of GUILT (Triti) in a young boy.

Back in America, Derek encounters the next strain of GUILT (Tetarti), which is only manageable after finding samples and using them to produce a few serums that are used to counteract the GUILT. Greg Kasal ends up being among those infected with the new strain, and is saved by Derek. Afterwards, Richard Anderson, the Head of Caduceus USA, becomes infected with a strain of GUILT (Pempti) that seems to be resistant to everything that is thrown at it. Eventually, Victor Niguel, Caduceus USA's head researcher, manages to come up with measures to defeat the GUILT and after much resistance, the strain is finally removed from Anderson's body. However, Anderson succumbs to the toll taken on his body and dies soon afterwards, leaving Hoffman as the new director of Caduceus USA.

Not long after this, outbreaks of Kyriaki, Triti, and Tetarti emerge and are thwarted by Derek and the other surgeons. Then, one night, a man breaks into Caduceus USA and ends up infecting Cybil with the sixth strain of GUILT (Paraskevi), though Derek manages to remove the parasite from Cybil's body. The man who broke in turned out to be Kennith Blackwell, the father of Derek's assistant Angie, and they manage to trail him back to a research lab. There, they encounter the final strain of GUILT (Savato), first an immature form within one survivor, and then the main form within Blackwell himself. Practically being death incarnate, Savato proves to be a difficult challenge for Derek, being so swift that not even his normal Healing Touch is able to let Derek deliver the final blow. Using the Healing Touch twice in succession, the Healing Touch intensifies to the point where time seems to stop, and Derek finally manages to destroy Savato.

Blackwell offers his full cooperation for saving his life and rejects Caduceus's offer of amnesty, wishing to serve out his term in prison to atone for his actions. Blackwell's information leads to a great wealth of knowledge about Delphi's operation and eventually the location of Delphi's headquarters. When Derek and Angie assist with a raid in cooperation with Caduceus Europe, they find that Delphi has been using children to incubate the seven strains of GUILT, and after curing the patients, Derek and Angie encounter Delphi's leader, Adam. What they also find is that Adam is practically a corpse, heavily infected with GUILT himself. Derek operates on all 7 strains and rids the world of GUILT. With the threat of GUILT eliminated, Derek becomes well known as the man who saved the world.

Second Opinion

North American cover of the Wii remake, Trauma Center: Second Opinion

In Second Opinion, an additional storyline focuses on Nozomi Weaver, another doctor with the Healing Touch. During her missions, it is revealed that she was working for Delphi, who knew of her ability and was using it for their own purposes. Nozomi remains mostly unaware of the circumstances of Delphi until just before their raid, and also places their operation in danger at one point by insisting on operating on a reporter wounded after chasing down a car in which Nozomi and a Delphi operative were passengers. Just before their headquarters are discovered by Caduceus, Nozomi escapes with a GUILT sample which she plans to use as a bargaining chip.

After Derek's Chapter 5 and Naomi's missions are cleared, Chapter 6 is unlocked. The plot of the chapter takes place at Caduceus Europe, where Derek and Angie have been invited to provide assistance and Dr. Hoffman has come to attend a conference held under near-total secrecy. There, Derek meets Naomi for the first time, who is now using her original name of "Dr. Kimishima" and granted amnesty in Europe, along with another doctor called Owen. Dr. Miller tells Derek about the Z-Cells, which are fruit of their research on GUILT in order to find a way to use it to help people.

After Derek eliminates a somewhat stronger strain of Tetarti, his heart becomes infected with a combination of Kyriaki and Paraskevi, which leaves Naomi to heal Derek. Angie volunteered to assist Dr. Kimishima, but at certain moments was unable to see Derek in the condition he was in, crying many times and jumping to severe conclusions. Naomi succeeds, and time passes, during which, Angie described her true feelings to Derek. During the scheduled conference where Dr. Owen explains how a patient has recovered from a wound after a Z-Cell injection, Naomi expresses her doubts, claiming that GUILT was created to kill people, and probably could never be used to save them. Soon after the patient suffers from an injury that causes his blood to spray all over the conference room, infecting all the attendees with various strains of GUILT.

After Derek and Naomi deal with the infected attendees, Owen tries to escape and reveals that he was working all this time for Delphi. Dr. Miller orders him to be stripped of his rank and taken away, and is then told that there is a problem in the lab where Adam is kept. Meanwhile, at the lab, Derek learns that the Z-Cells are taken from Adam himself, and that Hoffman has become infected with a strain of GUILT that is revealed to be a stronger version of Savato. In the final mission of the game, Derek and Naomi work together to take down the upgraded Savato and save Hoffman's life.

Afterwards, Caduceus International proposes a treaty to deal with GUILT research which is quickly ratified. As for Derek and Angie, they are revealed to be assigned to northern Afghanistan, but not much else is revealed in the main game - though Tyler Chase, talking to Leslie Sears and Stephen Clarks, claims that both Derek and Angie deserve a long holiday because lately, they did not have much time to spend together alone... Naomi reveals that she cannot leave Europe without facing criminal charges for her work with Delphi, and parts ways with Derek.


DS version

Aggregate scores
Aggregator Score
GameRankings 80.30% (58 reviews)[5]
Metacritic 81 (45 reviews)[6]
Review scores
Publication Score B[7]
AllGame [8]
Eurogamer 7/10[9]
Famitsu 31/40[10]
GamePro [11]
GameSpot 7.8/10[12]
GameSpy [13]
GamesRadar [14]
GameZone 7.9/10[15]
IGN 8/10[16]
ONM 80%[17]
X-Play [18]

In the January 2006 issue of Nintendo Power, Steven Grimm placed Trauma Center and its 9.0 score in the magazine’s review archive,[6] describing the game as “fiendishly addictive”. IGN gave the game an "impressive" 8 out of 10,[16] and Official Nintendo Magazine gave it 80%,[17] while GameSpot gave it a 7.8 out of 10, saying that it "succeeds because it strikes such a good balance between its medical theme and its puzzler roots."[12] X-Play reviewed this game and its remake and gave them both 4/5.[18] Also, Trauma Center has an average review ratio of 80% on Game Rankings,[5] while Metacritic currently ranks the game at 81%.[6]

Wii version

Aggregate scores
Aggregator Score
GameRankings 80% (57 reviews)[19]
Metacritic 80% (49 reviews)[20]
Review scores
Publication Score C+[21]
AllGame [22]
CVG 8.4/10[23]
Eurogamer 9/10[24]
Famitsu 32/40[25]
GamePro [26]
Game Revolution B[27]
GameSpot 8/10[28]
GameSpy [29]
GamesRadar [30]
GameTrailers 8.2/10[31]
GameZone 8.5/10[32]
IGN 8/10[33]
ONM 84%[34]
X-Play [35]

Reviews were mostly favorable. GameSpot and IGN both awarded the game with an 8/10.[28][33] Minor criticisms included the lack of a 16:9 aspect ratio.


  1. ^ "" (PDF). 
  2. ^ "Summer Loving from Nintendo".  
  3. ^ "Wii pwns Australia with 500,000 sold - Nintendo Wii Fanboy". 
  4. ^ "Behind the Scalpel - The Story of Trauma Center". Atlus USA presentes Trauma Center: Under the Knife.  
  5. ^ a b "Trauma Center: Under the Knife for DS".  
  6. ^ a b c "Trauma Center: Under the Knife (ds: 2005): Reviews".  
  7. ^ Nutt, Christian (2005-10-10). "Trauma Center: Under the Knife".  
  8. ^ "Trauma Center: Under the Knife Overview".  
  9. ^ Bramwell, Tom (2005-11-01). "Trauma Center: Under the Knife Review".  
  10. ^ "Caduceus - Famitsu Scores".  
  11. ^ "Review: Trauma Center: Under the Knife".  
  12. ^ a b Navarro, Alex (2005-10-06). "Trauma Center: Under the Knife for DS Review".  
  13. ^ "GameSpy: Trauma Center: Under the Knife Review".  
  14. ^ "Trauma Center: Under the Knife Review".  
  15. ^ "Trauma Center: Under the Knife Review".  
  16. ^ a b Harris, Craig (2005-10-07). "Trauma Center: Under the Knife Review".  
  17. ^ a b "Review: Trauma Center: Under the Knife".  
  18. ^ a b "Review: Trauma Center: Under the Knife".  
  19. ^ "Trauma Center: Second Opinion for Wii".  
  20. ^ "Trauma Center: Second Opinion (wii: 2006): Reviews".  
  21. ^ Fitch, Andrew (2006-11-16). "Trauma Center: Second Opinion Review".  
  22. ^ Sutyak, Jonathan. "Trauma Center: Second Opinion Review".  
  23. ^ "Wii Review: Trauma Center: Second Opinion".  
  24. ^ MacDonald, Keza (2006-12-20). "Trauma Centre: Second Opinion Review".  
  25. ^ "Caduceus - Famitsu Scores".  
  26. ^ "Review: Trauma Center: Second Opinion".  
  27. ^ "Trauma Center: Second Opinion video game review for the WII".  
  28. ^ a b Kasavin, Greg (2006-11-16). "Trauma Center: Second Opinion for Wii Review".  
  29. ^ "GameSpy: Trauma Center: Second Opinion Review".  
  30. ^ "Trauma Center: Second Opinion Review".  
  31. ^ "Trauma Center 2 - Review".  
  32. ^ Bedigian, Louis (2006-12-01). "Trauma Center - Second Opinion Review".  
  33. ^ a b Bozon, Mark (2006-11-13). "Trauma Center: Second Opinion Review".  
  34. ^ "Wii Review: Trauma Center: Second Opinion".  
  35. ^ "Review: Trauma Center: Second Opinion".  

External links

  • North American website
  • Trauma Center: Under the Knife at MobyGames
  • Official website (Japanese)
  • Official website (English)
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