The sequel to the first operating game "Trauma Centre: Under The Knife" on the DS is finally out. I've been anticipating this game since it was announced.

It's been three years since GUILT was defeated and now Derek Stiles and Angie Thompson are in Africa, Costigar treating patients in a war-torn country as voluntary doctors. Lacking equipment and staff, Derek soon meets his new trainee named Adel Tulba. Just when they begin settling down they are called back by Caduceus who have reports that patients were showing "Post GUILT Symptoms (PGS)".

Right from the beginning, I'm sure players will notice the change in presentation but I'll cover that later. First lets take a look at the gameplay which hasn't really changed but, that isn't a bad thing. The player is still given a patient to save under a limited amount of time while in-between, there's a large amount of dialogue to read through. Unlike its predecessor however, both stories and operations are neatly organised into replayable chapters, unlocked as you play much like the "Second Opinion" approach on the Wii. I prefer it this way because one can then replay an operation as much as they like or, just be allowed to review parts of the story.

As with the earlier titles in the series, the operations in the first two chapters still act as a set of unskippable in-game tutorials. After that, we see that Atlus has decided to bring in the content introduced in the first Wii game "Second Opinion" such as the defibrillator which, operates in a similar way. Players drag it to the middle of the screen then hold and release the stylus from the screen when the timing is right. I find it easier to time with the stylus than pushing the Wiimote and nun-chuk towards the sensor. The bone puzzles also make an appearance except this time they can't be rotated making them much easier to solve.

Besides the content from Second Opinion, it appears Atlus has decided to gather all the content used in the series so far into this DS sequel. I haven't played the second Wii title "New Blood" yet because it hasn't been released for Europe but, I have watched some clips of it so I know they've brought over the heart massage from that. Then there's also the skin puzzles too where one has to repair damaged skin. I guess this gives me some good preparation for when New Blood finally comes out over here!

There's also a noose tool but this only made one single appearance which made it felt as if the development team was just testing it out. Eventually players even get to use the mic so it's not all just reused content.

With all the content from the series gathered together in TCUK2 mixed in with the evolved strains of GUILT", it sounds like there's a lot to enjoy and indeed the operations can remain both challenging and fun. Being someone who has yet to play New Blood, some of the operations took some time getting used to and towards the end of chapter four, it was becoming fairly challenging on the normal setting. There's also quite a few other tricks used to increase the difficulty even further. Fortunately players now have the option to switch between three different difficulties now whenever they wish.

Taking a closer look at the interface, I've also noticed that the vitality bar now has a line on it so that players know when it has reached its maximum capacity. This means no wasting time time trying to keep it maxed out which I'm sure is a common strategy amongst Trauma Centre players. Other improvements over the first DS game is that one doesn't have to worry about the game not recognising circles properly to use the magnify tool. The tool is now merged with the ultrasound tool and simply allows the player to scroll around the screen by pressing down and dragging the stylus about.

It all sounds good so far but, while operating on the patients with PGS, I felt a bit of disappointment. This is probably due to the fact the operations dealing with the evolved "GUILT" work very similarly to the way they were carried out in the prequel and in Second Opinion - both of which I've replayed countless times already! Another problem that rails its head as the game progresses is the number of tools available. Eventually the touch screen begins to feel a little too cramped, making it a bit difficult to scroll about or select tools during the hectic operations.

On the presentation side of TCUK2, those who have played the first game's Wii port "Second Opinion" will notice immediately that this latest title in the series sports the same look. The graphics are cleaner and sharper looking using Masayuki Doi's character designs instead of the prequel's designs, which were done by Maguro Ikehata. There's not many new locations and characters to see but, I'm sure those who have played the first game will enjoy seeing the old cast back at Caduceus as they take on the aftermath of GUILT.

I think it's great to see some of the new characters being introduced using a tall double screen illustration. They should add in more of these event images in future Trauma Centre titles and offer an unlockable gallery!

As one may expect from a DS game, we don't see any full voice acting but what we do get is a greater variety of voice clips from the cast of characters which help liven up all the text reading. Saying that however, the odd phrase is still repeated a bit too often that it can become annoying. Fortunately, voices can be turned off under configurations.

As for those of you who are fans of Shoji Meguro's music, Atlus has yet again chosen a different composer again this time just like in "New Blood" but the soundtrack is still great to listen to.

In the end, I enjoyed the usual challenging gameplay from Trauma Centre: Under The Knife 2 and the cleaner graphics used on the Wii titles brought to the DS but, lets just hope this will seriously be the last time we'll see "GUILT" being used.

Time to Finish: 8 hours

Likes

• More of the same hectic challenging "Trauma Centre" operations.
• The cleaner sharper looking visuals introduced from "Second Opinion" being used.
• All previously introduced operation content brought together from the series.
• Seeing the old characters from the prequel.
• A greater variety of voice clips to liven up the text reading.
• Great soundtrack.
• Selectable difficulty level at any time.
• Replayable chapters right from the start.

Dislikes

• Touch screen eventually gets pretty cramped with tools.
• Curing similar GUILT diseases again.