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• Estimated trophy difficulty: 8/10
• Offline trophies: 56 (48, 5, 2, 1)
• Online trophies: 0
• Approximate amount of time to platinum: 30-50+ (heavily skill dependent)
• Minimum number of playthroughs: 1 (Will require many chapter select replays)
• Number of missable trophies: 0
• Glitched trophies: 4 (Best Surgeon In The World, Best Surgeon In The Universe, First Success and You Can’t Handle The Tooth!)
• Does difficulty affect trophies?: No difficulty option
• Do cheat codes disable trophies?: No cheats

Introduction 

Surgeon Simulator is a popular PC game that made it’s way to the PS4. The game purposely features clunky controls where you are a surgeon performing one of five transplants on Bob; your patient. The transplant surgeries include Heart, Kidney’s, Brain, Eyes and Teeth.

You will struggle with the controls and will almost humorously kill Bob over and over. The trophies will require much practice and patience. I can’t stress how important practice will be if you intend to get this platinum trophy. All references to direction such as left or right, are from the vantage point of the player, not the patient. I know that’s technically not the medical way to do it, but gamers are conditioned to call direction based on their viewpoint.

Walkthrough 

Step 1 – Play through the game completing each of the surgeries at each location – You will start the game in the Surgery room. This is the first location. Once you successfully complete the first operation, the next one will be open for you. Each location has five transplants that you must complete, with a total of 5 locations. For this step, just play each of them. You will slowly get better as you play and will start to feel a little more comfortable with the controls.

During this step, don’t worry about getting A++ ratings or completing them within the required blood loss that will net you trophies. However, there are a lot of miscellaneous trophies that you can go for, including some that you can get at the menu. See step 4 for a list of the miscellaneous trophies available.

Step 2 – Get A++ rating on all procedures – The trophy Best Surgeon In The World will require you to get a A++ rating on each procedure. You will need to quickly complete transplants without losing an exessive amount of blood. The good news is that at the time of this guide, the trophy should pop after getting A++ on all five transplants in the first location and the first surgery in the Corridor location. This may be glitched, but in a good way. You will earn two trophies during this step

 I Should Never Have Doubted Myself
 Best Surgeon In The World

Step 3 – Complete each procedures timed or blood loss trophy – There is a trophy for completing each procedure within a certain amount of time, or without losing more than “x” amount of blood. The first and third locations, Surgery & Ambulance, each are time trials. The trophy description will let you know how quickly you need to complete the procedure.

The second and fourth locations, Corridor and Space, will require you to complete each of them without losing a specific amount of blood. Once again, refer to each procedures trophy description to know how much blood you can safely lose. There technically is a fifth location, but that’s tied to the miscellaneous trophies in step 4. You will earn these trophies at the first four locations

Surgery
 Kali Mah!
 Don’t In-Test My Patience
 How Long Can You Live Without A Brain?
 Blink And You’ll Miss It
 You May Feel A Light Tapping

Corridor
 Don’t Even Need A Bucket
 Tunnel Vision
 The Brains Of The Operation
 Won’t Even Need Glasses!
 Open Really Wide

Ambulance
 Life’s Too Short
 A Surgeon’s Merit Is Based On Speed
 Brainstorm
 I Can See For Miles… Per Hour
 Not The Time Or Place For Precision

Space
 It’s Life Jim, But Not As We Know It
 The Surgery Of The Future
 Precision Instrument Time
 Expert Space Stalker
 Maintained Healthy Gums At Least

Step 4 – Miscellaneous trophies – There are a ton of miscellaneous trophies. These will range from simply answering the phone at the reception desk to finding the alien patient in space and performing 6 procedures on him. Refer to the guide for details on each of the trophies and how to earn them. The following trophies will be earned during this step

 What Have I Done??
 Hammer Time
 The Goggles Do Nothing
 Lumberjack
 Heterochromia
 You Can’t Handle The Tooth!
 Keyhole Surgery
 Like A Wet Paper Towel
 I’m Sure He’ll Live
 Vworrrp Vworrrp
 The Beat Of Your Heart
 Doctor Doctor, Give Me The News
 Nigel The Secretary
 About As Politically Correct As Fur
 It’s In! It’s In I Tell You!
 Nothing But Skull
 Call Trisha
 Enter The Code
 We’re Going On An Adventure!
 First Success
 I Have No Idea What I’m Doing
 Best Surgeon In The Universe
 What A Load Of Bull
 Let’s See That Sick Filth Again
 Screw The Prime Directive

 There Is Nothing More To Teach… 
Completed every achievement. Now go save lives!


 I Think I Got This 
Perform a heart transplant.

Story related, can’t be missed. This surgery is available at the start of the game. The heart transplant will require you to break open the rib cage, then pull out the lung and separate the heart from the attached arteries before replacing it with the new one. See Kali Mah! for specific tips.


 Kali Mah! 
Perform a heart transplant in under 1 minute 50 seconds.

This will require you to replace the heart quickly. Since this is timed, you shouldn’t worry much about blood loss. This surgery is not to difficult to complete within the time limit. You only need to break open the ribs on the right side, at minimum the top three. The hammer makes quick work of the rib cage or you can use the circular saw to gain access. The saw can create massive blood loss if you hit his body or attached organs, but it will be easier to get an A++ rating as there is less blood loss if you are careful. 

Once you have broken the rib cage open you can pull out the lung that is blocking your access to the heart. Discard the Lung and grab a scalpel or some scissors and then use that to break the arteries attached to the heart. There are a few points you need to hit and with practice you can detach them with precision that won’t cause much extra bleeding. But speed is of importance here so don’t worry about the blood loss. 

Once the heart stops beating (you can visually see it stop beating as well as hear the beat stop), you can reach in and attempt to pull it out, or you can just grab the new heart and drop it in. You may have to pick the heart up and drop it back in a few times if it doesn’t register the first time. Here is a video where I walk you through the process:

 Don’t In-Test My Patience 
Perform a double kidney transplant in under 3 minutes.

The double kidney transplant is tricky because there is a lot of cutting and pulling out of organs we need to do, as well as the extra difficulty in pulling out and putting in the kidney themselves.

Start by cutting out both the large and small intestines. The large intestines can be cut out by hitting the cut point in the lower right and in the middle on the left side. The cut points will be slightly more red than the rest of the intestines. The small intestines in the middle can be cut on the left near the cut point for the large intestines, and then another one along the top left where it attaches to the stomach. 

You will then need to cut the esophagus at the very top from the stomach which is located under the exposed ribs. The cut point is right where it meets the esophagus. You then need to remove everything from his body that you cut, including the liver above the left kidney (left as you’re looking at it). You will see the two kidney’s exposed with a yellowish cord attached to them. Use a cutting tool to detach these cords at the point they meet the kidney.

Once everything is cut, you can pull out the kidney if you can grab them. They are tough to grab so feel free to use the spoon to pull them out of there location. Then grab the two kidney’s and put them in. Here’s a video where I walk you through it:

 How Long Can You Live Without A Brain? 
Perform a brain transplant in under 1 minute.

The brain transplant is one of the easiest surgeries. You need to crack open and expose his brain. Make sure you crack it open enough that you can pull out the brain. You can use the hammer to make short work of the skull, or use the axe for a little less damage. If you use the axe, grab it near the blades and rub the flat sides around his skull. This will yield in much less blood loss. Once the brain is completely expose, pull it out and then sever the brain stem with any cutting device and grab the new brain and put it in. Here’s a video walkthrough:

 Blink And You’ll Miss It 
Perform an eye transplant in under 2 minutes and 30 seconds.

The eye transplant is a very tricky and quite involved surgery that can irritate you to no end. Since we’re going for speed, don’t worry about blood loss. Start by grabbing the scissors and cutting the straps on both side of the mask. Once that’s cut, use those same scissors and jab him in a open eye until the scissors are hanging on there own from his eye. You’ll then need to grab the scissors and pull them out of his eye and this will make his eyeball pop out a little. Repeat that process on the next eye. You want to use the scissors to jab his eye since it’s easier to grab them again. Scalpels are harder to re-grab.

After you have both eyes bulging out of the socets, you need to get them to hang out of the eye. You can do this by hitting the side of his head with a hammer, or with a black box holding the Q-Tips. Keep hitting him on the side of the head with as much force as you can deliver until both eyes are hanging out.

Once they are out, pick up a scalpel and use extreme precision to cut them out of his head. You can do this by cutting the point in the middle of the expose steams attached to each eye. Taking it slow and carefully is a better option as long as you are precise with your movements.

After both eyes drop to the floor, empty out one of the bottles containing the eyes into the green tray right in front of you. Now the tricky part. You need to pick up an eyeball (:r1) and maneuver them into the eye. For the first one, you’ll need to let go of your  button once it’s in place. The second one you can just keep holding it until the game gives you completion. This surgery will take some practice. Here’s a video guide of me doing it:

 You May Feel A Light Tapping 
Perform a teeth transplant in under 3 minutes.

The teeth transplant is not to bad. What you need to do is cut open the mask covering his mouth. Once you have the mouth revealed, grab the small hammer and knock out his rotten teeth. Try to avoid knocking out many good teeth, but if you do, just remember the location of the rotten teeth. To complete this surgery, you have to put good teeth in the location of the rotten teeth. 

You can use any teeth to replace them. To pick the teeth up, you’ll have to use the tweezers. The teeth will stick to the end of them like magnets when you get close enough, and then will automatically attach to his gums once you are close enough. Just remember to put them in the spots where the rotten teeth once were. If you didn’t knock out to many extra teeth, it’ll be easier. Here’s my video guide of this procedure

 Like a hotdog down a hallway. 
Perform a corridor heart transplant.

Story related, can’t be missed. This operation won’t be available until you complete all the procedures in the Surgery location. All the procedures in the Corridor are exactly the same as the first location, with the exception of you running down a hallway with carts coming and going. You’ll be spending a lot of time waiting for a cart with your tool of choice.

 Don’t Even Need A Bucket 
Perform a corridor heart transplant losing less than 900ml of blood

Time is not important for this, or any of the Corridor trophies (unless you want A++). The first thing you want to do is find the green needle. The green needle will stop any bleeding you cause to the patient. Depending on the amount of blood loss per second, you may need to stab him a few times with it. Just place it on him somewhere where you can retrieve it as needed.

The next thing you need is the circular saw. This will allow you to cut out the ribs with the least amount of blood loss. You only need to cut out the top three ribs, from the center to the right. Any additional cutting will dramatically reduce your chances of staying above 4700ml Blood Level.

Once the ribs are exposed, pull out and throw away his lung. Then grab a cutting tool and separate the heart from the arteries. you can do this without adding any blood loss per second if you know exactly what you’re doing, however, if you do manage to create blood loss, make sure to quickly poke him with the green needle as often as required to prevent him from losing blood.

Once the heart stops beating, pull it out if you can, or just throw the new one in. Remember, you are not being timed for this trophy so you are able to take your time.


 Tunnel Vision 
Perform a corridor double kidney transplant losing less than 800ml of blood

This one can be tricky. You’ll definitely need the green needle before starting any cutting. Put the needle on him, out of the way. Do exactly the same steps from the Don’t In-Test My Patience, but stopping to hit him with the needle in the blood loss per second is building. If you aren’t losing any blood, just remember that you can take your time and make precision cuts. You will need to have a blood level above 4800 when you complete this procedure to earn the trophy.

 The Brains Of The Operation 
Perform a corridor brain transplant losing less than 750ml of blood.

The brain surgery is tough to avoid losing blood in since every time you hit the skull, his blood level will drop. I found that using the flat side of the axe and rubbing it around his skull will chip most pieces away with the least amount of damage. Use it until you have most of the brain exposed, and if you need to chip a little on the sides to get the brain out, use the hammer. 

Any direct impact to the brain itself will cause massive blood loss and you’ll have to restart. Once you have pulled the brain out, make sure to stab him with the needled before cutting the stem if there’s any gradual blood loss. Then cut the stem and put in the new brain.

 Won’t Even Need Glasses! 
Perform a corridor eye transplant losing less than 1250ml of blood

This can be tricky since you will need many things and will have to wait on the cart with the right item. Obviously, grab the green needle first. Follow exactly the instruction from Blink And You’ll Miss It for this. The only change is that you don’t want to poke his eyes with scissors. Instead, use the black pen to stick it into his eye. The pen causes little to no damage at all. Then make sure to use a non damaging item to knock the eyes out of his head such as the small black box. This won’t cause any damage.

When you are cutting each eye, make sure to stick him with the green needle after cutting out the first eye and after cutting out the second eye. Remember, you can take 20 minutes to complete this, so take your time and be precise. Once you have both eyes out and you stopped the bleeding, simply take your time in putting in the new eyes and if your blood level is above 4350, you will get this trophy.

 Open Really Wide 
Perform a corridor teeth transplant losing less than 550ml of blood

This one will require a ton of precision. First, make sure you have the green needle handy. You will need to use that after knocking out the rotten teeth. Ideally, you want to have the rotten teeth all near each other. This will lesson the chances of you causing extra blood loss. You need to complete this with at least 5050 blood.

After removing the mask, use the small hammer to carefully knock out the rotten teeth as outlined in the You May Feel A Light Tapping guide. If you knock out the rotten teeth and then stop the bleeding with the green needle, you can take your time putting in the new teeth provided you don’t accidentally stab him with anything.

 Nine Nine Nine! 
Perform a heart transplant in an ambulance.

Story related, can’t be missed. The ambulance location will be available to you once you have completed all the procedures in the Corridor. To complete these procedures, it’s done exactly has they are in the first location but the added difficulty will be that you are in the back of a moving vehicle that will often swerve back and forth and hit potholes. This will cause all the tools to start flying around. 

 Life’s Too Short 
Perform a heart transplant in an ambulance in under 1 minutes 40 seconds.

The ambulance time trials are exceptionally difficult. The times required are going to be less than they were in the Surgery location and with everything moving around, it’s going to test your patience. Complete this the same way you complete Kali Mah!. The one positive we have in being in the ambulance is that organs that are cut from Bob will often just fly out of his body on their own. Here is a video of this being completed:

 A Surgeon’s Merit Is Based On Speed 
Perform a double kidney transplant in an ambulance in under 2 minutes.

This double kidney transplant has to be completed 1 full minute quicker than the last time trial where you earnedDon’t In-Test My Patience. You will need to be exceptionally fast for this one. I would recommend grabbing the bone saw on the left side of the ambulance at the beginning and use this to cut everything, including the yellow veins attached to the kidney’s before letting go of the tool. You can cut them with the intestines still in the body. 

Once you have cut everything and removed everything, the trick will be to placing the two kidney’s inside of him. You will need to place one in its’ spot and then quickly place the other one in before it fly’s away. Watch this video to see it in action:

 Brainstorm 
Perform a brain transplant in an ambulance in under 1 minute 30 seconds.

All of the ambulance timed trials are very difficult, but this is the easiest of the bunch. You actually have 30 additional seconds from the first stage brain transplant. Use the axe, or hammer to cut out the skull to reveal the brain. Just be careful that you don’t hit the brain itself as that will become a quick death for Bob. 

After you expose the brain, pull it out and cut the brain stem with a scalpel or scissors and then place the new one in. This video will show you the way:

 I Can See For Miles… Per Hour 
Perform an eye transplant in an ambulance in under 2 minutes and 10 seconds.

Earning this trophy will prove to everyone that you are a master surgeon. It will take much skill, precision and patience to complete. Do all of the steps from Blink And You’ll Miss It. I would recommend using the hammer to get the eyes to fall out of his head as it could save a few seconds. There is two tricky parts. The first will be cutting the eyes with the scalpel as the moving ambulance won’t do you any favors. The grabbing the new eyes to put into his head will test your patience. 

With the ambulance moving around, the eyes will bounce around and roll all over the place. You must be quick at picking up the eye and putting them into his head. Practice will make perfect on this very difficult trophy. Here is a video of me doing this:

 Not The Time Or Place For Precision 
Perform a teeth transplant in an ambulance in under 1 minute and 50 seconds.

For this, you’re going to hope that all the rotten teeth are near each other, preferably all on the top near each other or on the bottom. This is because it’ll be very easy to put in a new tooth in the wrong spot. The location of the rotten teeth is random each attempt.

The challenge on this one will be all the extra stuff on the right side of the ambulance that will fall around the tooth containers. If you’re quick, as I will show in the video below, you want to ideally try to clear out the space around the new teeth. But don’t spend more than 10 seconds or so doing that. 

Picking up the teeth with the tweezers will also prove to be pain in the rear end since the controls on the moving ambulance are even more difficult. You have to remember that you need to put new teeth in the location of where the rotten were at. It doesn’t matter which tooth you use, but they do have to go back into the original rotten tooth’s spot. This is why you need to try only breaking out the rotten teeth. You have time to put up to four teeth in his mouth, so three of them will have to be precise. Here’s my video walkthrough:

 In Space, No One Can Hear You Bleed 
Perform a heart transplant in space.

Space is unlocked once you have completed all procedures in the Ambulance. The difficulty here will be that everything will be floating around you. Bumping into an object will send it flying around bumping into more things. Nothing you can do about that. The upside is that parts will float out of his body automatically, but so will parts you’re trying to put in. 

One additional challenge in this will be actually trying to grab items. The game is not very forgiving when attempting to grab items, especially when they are twirling around in space. It’s going to take practice to be able to grab things consistently. 

 It’s Life Jim, But Not As We Know It 
Perform a heart transplant in space losing less than 800ml of blood.

The one problem with space is that the green needle can’t be sitting there waiting for you to pick up. It will fly away, oftentimes in locations you can’t reach.

Perform this operation exactly as you have for the Don’t Even Need A Bucket trophy. This time you will need to have a blood level above 4800. Use the circular saw to carefully open up the right side rib cage without adding any blood loss. Then pull out the lung and you’ll need to very precisely cut out the heart. Avoid extra blood loss.

I would recommend not cutting the heart out until the green needle is in a location you can easily grab. If you create blood loss, you’ll need to stop the bleeding immediately after cutting the heart out. Since you are not timed on this or any of the space blood tropheis, it’s best to babysit your green syringe for all of them. When you are holding it and want to let go of it, hold it with just . Move your hand down towards the table very slowly. Just before reaching the top of the table let go of your syringe and it will come to a near stop on the table. You have a minute to work without having to worry about it unless you have other stuff moving around. Sometimes it’s just best to wait until everything settles down before dropping the needle.

 The Surgery Of The Future 
Perform a double kidney transplant in space losing less than 700ml of blood.

Perform this operation the same way you performed the Tunnel Vision. Thankfully, being in space will make most of the parts fly out on their own. You’ll need to be able to grab the green needle after making your first cuts. I’d aim to cut out everything except the kidney’s, then needle him, then cut the cords on the kidney’s and needle him again making sure you have the syringe readily available before cutting the kidney cords. 

Once you have cut and removed everything, if you’re still above 4900 blood, you can take your time. However, be careful that other objects don’t float into Bob and cause more blood loss. Putting in the new kidney’s can be a challenge since they will try to float way. After putting in the first one, quickly try to put in the second one. You’ll probably have to go back and forth between them and realigning them before getting success.

 Precision Instrument Time 
Perform a brain transplant in space losing less than 600ml of blood.

This is the hardest Brain transplant related trophy. You have to maintain a blood level above 5000 and it doesn’t take much to go beyond that. I would recommend using the side of the axe blades and scrapping the skull away. Try to do this without causing the blood per second to increase. 

With his brain exposed, it’s possible for other objects to come into contact with it and cause massive damage so just beware. Assuming you haven’t increased the blood loss rate, cut the stem and then quickly put in the new brain.

 Expert Space Stalker 
Perform an eye transplant in space losing less than 1000ml of blood.

This one is quite challenging since the green needle is vital here and it can be difficult to find and retrieve. You will definitely have to babysit your syringe in this one as you’ll have to use it a few times. Use the tip in It’s Life Jim, But Not As We Know It to avoid losing the syringe. Right off the bat, the blue needle will be to the right of his head. I would recommend grabbing the scissors just below you when you start and just to the right. Use this to cut of the mask. Cut the right side first but before you do that, slightly knock the blue syringe sitting right next to his head. Then proceed with cutting the mask. Beware, that blue syringe you moved can bounce back and hit Bob at any point and it’ll guarantee a restart.

Unlike the strategy for Won’t Even Need Glasses! where I recommend using the pen to poke his eyes to prevent blood loss, use the scissors and quickly poke and pull out each of his two eyes. You risk more blood loss, but you’ll lose more trying to find and grab the pen. If the pen works for you, go ahead and use that. The green syringe should still be in its starting place up high and to the right of you. Quickly grab that and stick Bob with it. You should be around 5000-5200 blood.

At this point, you will have to keep your eye on the green syringe at all times. Wait until everything stops bouncing around and then place the syringe on the desk to your right. Hopefully things won’t be bouncing into it. To knock the eyes out, use the black box if you can find it, or the glass jar will also work. Anything else will cause damage to Bob. Remember to keep an eye on the syringe. If it starts drifting to far away or if something is about to hit it, you want to stop everything and keep it safe.

With the eyes hanging out, you’re going to have to grab a scalpel and cut the stems. Remember to only hit the middle of the stem. Avoid the eye and Bob himself. You can carefully do this without losing more than 100ml of blood if you’re good. After dropping one eye to the floor, stick Bob with the Syringe if you have any amount of blood loss going on, then go after the second eye and stick him again with the syringe once done. At this point you just have to get the eyes in and you’ll win. I finished with 4967ml of blood remaing, but you only need to be above 4600 to get the trophy.



 Maintained Healthy Gums At Least 
Perform a teeth transplant in space losing less than 600ml of blood.

This has the same strategy as the Corridor’s Open Really Wide trophy, but you are given an extra 50ml of blood this time around. There are a couple small hammers that should be easy to get but before you start whacking away at his teeth, make sure you can quickly access the green needle. You will have to quickly stop the bleeding.

Make sure that you are very precise with the small hammer and avoid knocking out the good teeth. Just try to hit the rotten ones. It’ll be a little tougher this go round since his mouth will keep closing. Once you have the rotten teeth out, stick him with the green needle as many times as required to reduce his blood loss rate to zero. Assuming you’re over 5000ml of blood, just take your time in putting the new teeth with the tweezers being careful not to knock any of the floating objects into Bob.

 I Immediately Regret This Decision 
Electrocute and drug yourself at the same time.

Electrocuting yourself is done by sticking a scalpel into an electrical socket. You drug yourself by touching the tip of the green syringe. You will want to drug yourself first as electructing yourself will result in your  controls being inverted. 

 And They Said It Was Impossible! 
Complete a procedure after being drugged and electrocuted. (Must be afflicted within 20 secs)

Drug yourself by touching the tip of the green syringe and electrocute yourself by sticking a scalpel into a wall outlet. You need to do both of these within 20 seconds of starting any procedure. Once afflicted, you need to complete a procedure. I would highly recommend the brain transplant as it’ll be the easiest. Remember, shocking yourself will result in your  controls being inverted so just take your time and try to avoid creating a massive blood loss rate or just use the green needle as needed.

 What Have I Done?? 
Lose the patient within 15 seconds.

There are many ways to do this. A quick and easy way to do this is to start a brain surgery and just grab the circular saw and use it to crack the skull and keep hitting the brain. If you kill Bob within 15 seconds, this trophy will pop

 Hammer Time 
Lose 50,000ml of blood using the hammer.

50,000ml of blood loss is cumulative. Just keep replaying surgeries and use the hammer on him until he dies. Should be pretty simple. Hitting the exposed brain in the brain transplants will be quickest if you need to farm this.

 The Goggles Do Nothing 
Completely smash up the goggles.

Start up the eye transplant procedure and grab the hammer and start using it while the goggles are still on Bob’s face. You’ll need to smash the front of them as well as each side. Leave at least one side strap until last otherwise the glasses will fall to the table, or floor, and it makes it more difficult to smash them.

 Lumberjack 
Cut out the eyes using the surgical axe.

This can be done on any eye transplant. It’s probably best to use the Surgery location. After you have knocked the eyes out so that they are hanging out of his head, pick up the surgical axe and use that to cut the eyes so that they fall to the floor. It will probably create a bunch of blood loss, but it’s worth it for a trophy.

 Heterochromia 
Give the patient heterochromia.

Heterochromia is a medical term used to describe people with two different colored eyes. For this trophy, you need to perform an eye surgery and put one blue eye and one brown eye into Bob. The pupils are what you are looking at to differentiate the eye color. 

 You Can’t Handle The Tooth! 
Complete the tooth transplant only removing the rotten teeth.

Glitched

This trophy requires you to do a teeth transplant and only remove the rotten teeth. This requires a steady hand and some patience. You can knock out a tooth by using the small hammer and hit it against the rotten teeth. There will be three rotten teeth. 

Be very precise and use slow deliberate movements to hit the teeth. Once you have removed the three rotten teeth, you will need to complete the transplant by putting in three new teeth in the newly created openings in the gum line. The trophy should pop once complete, however, this trophy is glitched and is impossible to earn at this time.

 Keyhole Surgery 
Completely remove the rib cage.

This one is a little temperamental. Load the first heart transplant level and use the circular saw to cut the entire rib cage out from each of the points where it connects to the body. You’ll need to get really close to the body, but be careful not to hit Bob. You can then pull the entire rib cage out as one piece.

The game did not register the trophy for me on my first couple attempts, but did on my third attempt. 

 Practically Licensed 
Complete all procedures.

Story related, can’t be missed. You need to finish all the procedures in each location up through the space locations. The alien procedures don’t count towards this.

 I Should Never Have Doubted Myself 
Get an A++ rating on a procedure.

See Best Surgeon in the World.

 Best Surgeon In The World 
Get an A++ rating on all procedures.

Glitched

A++ ratings require you to complete the surgery with a good time and with little blood loss. If you use the time trials and the blood loss trophy benchmarks from the first two locations as a point of reference, combine the two and you’ll easily get A++. The game does allow you to add about a minute of time and a little more blood loss to still get an A++ rating, so the time and blood loss is not as strict as the trophy requirements. If you can the time trial trophies in Surgery and the blood trophies in Corridor, you should have no problem getting this.

This trophy is glitched, but positively so. The trophy is popping after the 6th procedure. So that means you just need to get A++ rating on the first five in Surgery and then the first one in Corridor.

 Like A Wet Paper Towel 
Throw the new heart away in the surgery.

Start a new Heart Surgery in the first location and go straight to the new heart. Pick it up and throw it off the screen to the left for this easy trophy.

 I’m Sure He’ll Live 
Complete a procedure with less than 10ml of blood remaining.

This is fairly easy. Just get a procedure done up until the point where you just need to drop the transplant to finish. For example, start the brain surgery and after you cut the brain stem, cause enough damage so that his blood level decreases and when he’s under 10ml of blood, put in the brain.

You can use the blue needle to accelerate the blood loss rate and slowly reduce the rate using the green needle, making sure to stop it before he dies.

 Vworrrp Vworrrp 
Create a Time Lord.

This is another easy one and also a Dr. Who reference. You simply need to do the heart transplant and put in the new heart while the first one is still beating.

 The Beat Of Your Heart 
Replace the heart with something else.

This can be done on any Heart transplant. Completely open up Bob’s ribcase and cut everything out including is old heart. Once you have him complete open, toss in the alarm clock radio and you’ll get this trophy. You may have to maneuver it around to register the trophy.

 Doctor Doctor, Give Me The News 
Answer the phone.

The phone is in the reception area (menu). Wait a little bit and the phone will start ringing. Just pick it up and you’ll get this easy trophy. 

 Nigel The Secretary 
Go about your secretarial duties.

This is earned in the reception area. Simply grab a pen and start writing on the notepad to the right.

 Spaaaaaaaaace 
Go where no surgeon has gone before.

Story related can’t be missed. You will be able to go to space after you have completed all the Ambulance location procedures.

 About As Politically Correct As Fur 
Give the patient a… scarf.

You can get this during the Double Kidney transplant. Cut out the large intestine and use that to wrap around Bob’s neck. If the trophy doesn’t immediately pop, just keep adjusting it until it does.

 It’s In! It’s In I Tell You! 
…and it was going so well.

This requires you to do the Heart Transplant and have the heart in the chest cavity without it registering as in. Then just kill Bob off.

 Nothing But Skull 
Complete a brain transplant by throwing it in.

This one is tricky. Go to the brain transplant and open up the skull as much as you can. Make sure to give Bob a green needle if your blood drops quickly. You need to throw the brain into the open skull to complete the procedure.

You can grab your new brain and with the brain facing down, flick your wrist and let go of  at the right moment, or you can twist your hand completely around so that the brain is facing up and then just move your hand a little forward with  and let it roll off your fingertips and into the skull.

I found that holding it with the hand backwards and the brain facing up to be easier. You will have to hold your hand as far back as you can go and only move it forward slightly. If you get to close to Bob, it won’t count as a throw.

 Call Trisha 
Now where did you leave her number…

You may have seen dozens of post-it notes everywhere that say call Trish. If you call Trish, you will get a trophy. You call her from the phone at the reception desk. Use the phone to enter her phone number.

Trish’s Number – 099326071850

Make sure there are no digits on the LCD read out on the phone. Clear the digits by hitting the red end button on the bottom left. Because your fingers are fat and clunky, It is easier to pick up a pen and use that to do your button pushing, plus you can see the shadow from the tip of the pen on the keypad. You may also wish to wedge the phone in front of the VCR at the bottom right corner of the desk to wedge it in there so the phone doesn’t slide away. If you enter an incorrect digit, just hit the end button. If you enter all the digits correctly, hit the green call button.

 Enter The Code 
I’m not sure that was worth it…

You simply just need to go to the Brain Transplant surgery in Space and enter the code 296145 into the panel in the back right corner. This is kinda challenging to do. Just hold  and get close to the panel. Try to hover in front of the panel and move your hand around and tap forward on the  when you are over the number. It’ll take a little bit to get. 

After you enter the code, grab the radio and take it with you as that is the next trophy.

 We’re Going On An Adventure! 
Take your radio with you.

In the space location where you do the brain surgery, there’s a keypad on the back right wall. You need to enter 296145 and you’ll be taken back to the reception desk. To get this trophy you need to pick up and hold the radio after entering the code and before you warp back to reception. You’ll have plenty of time to grab the radio before you take off. 

 First Success 
Complete an alien organ transplant.

Glitched

After entering the code that earns you the We’re Going On An Adventure! trophy, you will need to conduct one of six random transplants on an alien. Complete the procedure to earn this trophy.

 I Have No Idea What I’m Doing 
Smash all canisters within 10 seconds.

In the alien transplant operating area, there are six glass canisters holding all alien body parts. Grab the spinning blades on the desk to your left and use it to destroy each of the six canisters within 10 seconds of starting.

 Best Surgeon In The Universe 
Complete all 6 secret transplants.

Glitched

There are six different operations available in the Alien surgery room. Which one you get will be random. You need to complete all six of them for the trophy. If you get one that you have already completed, just hit restart and you will be brought back out to the touchpad. Re-enter the code and you will be given a new random operation. 

There is no green needle so any blood loss rate that is added is permanent and you’ll have to correctly guess which of the six body parts you need to transplant as all the organs are available in the glass canisters (The ones you need to break for I Have No Idea What I’m Doing). Luckily, you can refer to which part you are transplanting below. The six operations are:

• Pewdsball (The red and black thing under the rib cage at the bottom)
• Gavichal (The orange thing in the top right with the spikes coming out from it)
• Birgirspallex (Left side in the middle. It’s purple with green spots on it)
• Robbaloraz (Looks like dark blue intestines near the bottom)
• Gobbleshaft (Blue thing in the middle with six light blue objects attached to it)
• Cubed Trangrifier (Black cube with the blue light below the orange Gavichal)

At this moment, the the operations are bugged and you can’t complete them. This will need to be patched.

 What A Load Of Bull 
Listen to the surgeon rap.

You can listen to Dan Bull’s rap from the alarm clock radio. You can get this to play anywhere, including the reception desk. Pick up the radio and bang it around a bit and it has a chance to switch songs, one of which is the Surgeon Rap. You’ll have to hit it hard against things, and even then it can still take a little bit of time to start playing.

 Let’s See That Sick Filth Again 
Perform a 180° spoon flip.

Load up the first location’s kidney transplant surgery. To the right is a spoon. You can grab it straight on and then hold it with your palm facing up. Flick you controller and let go of the spoon and it should go up and you’ll need to catch it. It’s pretty tough.

The way I did it was by picking it up sideways with the head of the spoon to the left. Then I turned my palm upwards so the head of the spoon was now facing to the right. I then barely twisted my hand to the left while letting go of the spoon and caught it again. It barely left contact with my own hand.

 Screw The Prime Directive 
Reveal your next patient.

After completing the Enter The Code trophy where you entered the code 296145 in the Space Brain procedure, you are brought back to reception where a new VHS tap will be waiting for you. Grab that tape and enter into the VCR to the right of it. This will take you to a new area where you have another touchpad in front of you. This time, enter the code 4948 and you will discover a new patient.