Although real-life surgeons have to make it through what seems like half a century of medical school before they can face the pressure of putting patients' lives in their hands, Nintendo DS owners can just play a few chapters of Trauma Center: Under the Knife. This surgical sim, released by Atlus in 2005, put players in the scrubs of Derek Stiles, a talented young doctor faced with a bioterrorist threat that he must eradicate one operation at a time. After a pair of Trauma Center spin-offs on the Wii, Atlus will be releasing a sequel to Under the Knife for the DS next month. We've spent the past few days playing Under the Knife 2 to get a feel for what you can expect when it's released early next month.

　　The story has advanced by three years, but the medical technology feels very familiar.

　　Under the Knife 2 takes place three years and half a world away from the original game. Still assuming the role of Derek Stiles, you and your trusty nurse Angie Thompson have volunteered in the African republic of Costigar. The country has been steadily improving since it was torn apart by civil war, but it's by no means a safe place to be. This is evident in the first few surgeries that you'll be performing, which range from bullet wounds to mysterious infections unseen in other parts of the world.

　　In terms of characters, the big new addition this time around is a Costigese native named Adel Tulba. His knack for surgery and impeccable English make Adel a prime candidate for the mentoring services of Derek. And that's the story that proceeds to unfold: Although Adel is supremely talented, he is still raw and uncertain of his own abilities. Derek and Angie must guide him through the travails of becoming an advanced surgeon.

　　It's not long into your stay in Costigar that you discover the reemergence of GUILT, a disease engineered by a terrorist organization called Delphi. The disease itself hasn't fully returned, but troubling aftereffects have begun to pop up in various patients. It's because of this startling news that you put your volunteering services on hold to go fight this bioterrorist outbreak. The story then spirals towards new settings and new characters, but this is foundation on which the game begins.

　　The surgical procedures that punctuate the game's elaborate storytelling feel quite similar to the original. You're given a set list of goals for an operation and a timer in which to achieve those goals. You'll need to repair broken bones, remove tumors, and dislodge crocodile teeth, just to name a few. Most of the tools you're using are carried over from the original. The scalpel is used to open flesh, antibiotic gel to disinfect, the drain to clear blood pools, forceps to remove foreign objects, and the needle to suture the wound shut. When things get tricky, you'll need to use the defibrillator to resuscitate a patient who's gone into cardiac arrest or, at more critical moments, call upon the power of your magical Healing Touch ability.

　　The surgeries tend to be just as challenging. You need to have steady hands and a good grasp of what each tool is used for when performing operations. This is the case no matter which of the game's three difficulty levels you choose to inhabit. The easy difficulty still puts the pressure on you in terms of the mechanics involved; you'll just run into fewer unforeseen complications.

　　Trauma Center: Under the Knife 2 is scheduled for release on July 1 for the Nintendo DS. You can look forward to seeing our review at that time.