Surgeon Simulator (formerly Surgeon Simulator 2013) is the full version of the prototype of the same name. The game is a comical take on performing organ-replacement surgery from a first-person perspective. Surgeon Simulator does not attempt to take a realistic medical approach, in part due to the nature of the controls.
The game was originally called "Surgeon Simulator 2013," and the full version was released initially on Steam on April 19th, 2013 for Microsoft Windows, OS X, and Linux. It was renamed to "Surgeon Simulator" on August 14, 2014, when the Anniversary Edition was released.
A signature aspect of Surgeon Simulator is its unique and challenging controls. Players control the surgeon's hand motion with the mouse and bend fingers with the keyboard. The difficulty in performing precise movements often leads to humorous accidents, such as dropping the patient's lung out the back of an ambulance or getting a bone-saw stuck under the patient's intestines.
To make completing the game more manageable, Surgeon Simulator is not medically realistic. Players are free to remove and discard any organ they can reach, and are only required to replace the organ being transplanted. The replacement organ does not need to be sewn into place, but merely dropped in roughly the right location in the chest cavity.
The player is free to misuse medical tools, for example shattering the ribs with a hammer or cutting the intestines with a bone saw.
An operation can be failed by allowing the patient to bleed out, or dropping the replacement organ somewhere where it can't be reached (although the game will not notify you of failure in the latter case). Patients will start to bleed as incisions are made, with bleeding occurring much faster when cutting in the wrong place. Many operations contain a hypodermic needle that can be used to stop the blood flow.
There are three standard operations, broken into three tiers. The operations are heart transplant, kidney transplant, and brain transplant.
The first tier is a regular operating table with no environmental hazards.
The second tier is the back of an ambulance; the ambulance will bounce while driving, causing the player's medical tools and any loose organs to scatter around the ambulance. Sometimes the rear door will pop open, and any loose item may fall out the back of the ambulance.
The third tier takes place in space; the player's tools start out scattered around the operating room, floating in zero gravity. This mode can be especially challenging since any object that gets put in motion may bounce around the room, hitting other objects and sending them all flying. Objects can float above the player's reach, forcing the player to wait and hope they come down or try to throw other objects to bounce them back into range.
An initial version of Surgeon Simulator 2013 was created for the Global Game Jam in which the team had 48 hours to make a game with a specific theme. The theme for Global Game Jam 2013 was announced via a video in which a human heart could be heard, the theme was the 'sound of a heartbeat'. Global Game Jam participants were also given a list diversifiers, a free-for-all voluntary list of secondary constraints which would help diversify the entries in the worldwide challenge. The team chose a single diversifier: I’m Board: Make a game that is inspired by, but not a simulation of, a popular board game. The Global Game Jam version can be downloaded from the Global Game Jam website.
Regarding the unusual control scheme, the team found that any other control scheme that it experimented with, including more traditional layouts, simply didn't feel right. The team initially wanted to assign a key to each finger, but soon realized the player would be unable to move their hands around or pick stuff up and instead only mapped one hand to the keyboard, and used the mouse to move around.
The developers were initially unsure of whether or not the game was "genuinely" funny. Although they found themselves laughing they were not sure if it was the game or their sleep deprivation causing it. It was only when they finally presented the prototype to the audience that they realized the comic potential.
The released game is a full version of the original Global Game Jam title and took less than three months to put together. "The decision to make it our next game actually came after the huge response on the internet," said Bossa Studios designer Luke Williams. He believes that creating a game that is just as fun to fail at and to watch is key to drumming up huge support online. "YouTube is the reason the game is where it is," he reasons, although he adds, "We were never aiming for the game to do really well in videos." Williams believes that part of the appeal of watching Surgeon Simulator videos is that non-gamers can easily understand the absurdity of the game, and can treat is as a video in its own right, rather than a video of a game.