Tumors are found in many missions of Trauma Center games and will drop vitals until they are successfully removed. Some even create polyps which must be burned off with the laser - the wounds left behind are then treated using antibiotic gel.
The method of tumor excision in the Trauma Center series is called the "Powell Procedure." It must be carried out as follows:
- Find the tumor using the Ultrasound (note: leaving a tumor unattended after disclosing it will cause it to fade from view)
- Incise the middle of the tumor vertically with the scalpel
- Drain the cytoplasm (note: leaving too long a gap between draining and excising allows more cytoplasm to ooze out, breaking the chain and leaving you to repeat the drainage)
- Excise the tumor around the edges
- Place the tumor on the tray using the forceps
- Cover the wound with a synthetic membrane
- Apply antibiotic gel to the membrane to set it
- (Under the Knife only) massage the membrane with your hand
- Treat any polyps formed in the process
Tumors are slightly different among the various games.
There is no immediate loss of points for losing the tumor's signature by waiting too long to incise after using the ultrasound, but you will not get the full 2000 points at the end of the operation if you allow one to disappear from view. The best course of action is to go through the operation and memorize the tumors' locations, then try it again and cut them all out without any ultrasound use. Also, Under the Knife requires an extra step to finish the process, as noted above. To get a "cool," you must massage the membrane in a wide circle while not moving your stylus off the patch.
The tumor's removal will grant only a "good" if you had to use the ultrasound to find it. Again, memorization is the best route. Play through and remember the locations, then come back and cut them all out from memory. This will result in a large boost in points from getting "cools" instead of "goods."
The ultrasound works slightly differently, in that you're able to scan the area for tumors without needing to hit the A button to see where they are. Scan the area, but don't hit the A button, just select your scalpel and incise it where you saw it. This will grant a "cool" rating. Be sure to watch for any smaller polyps that form after the tumor is removed; burn them with the laser if any are present, then apply gel to seal the wounds. If any blood pools around one, drain it quickly and continue the operation.
Tumor removal is much more lenient in this game. Unlike the other games, a "cool" rating can be obtained even if the tumor shadow is locked on. However, there are still special bonuses for the amount of times the shadow disappears. Lower ratings will only be given if the tumor is dropped during extraction.
At some points in the games, the player is also presented with "unusual tumors", in Under the Knife 2 these are caused by the patient developing Post Guilt Syndrome (PGS), which appear on the surface of the organ and are supported by 3 blood vessels. Over time, the tumors will create polyps, which will add to the vital damage.
First, drain the tumor's cytoplasm. Unlike other tumors, it would not spill out once it is drained. Next, the blood vessels need to be severed with the scalpel before the tumor can be safely extracted. Once the tumor is extracted, remaining polyps need to be treated.
However, if a tumor is extracted while there is at least one unsevered blood vessel, all extracted tumors will regenerate. To ensure that everything is extracted safely (and to get the "Tumors did not regenerate" bonus), extract all the tumors once all the blood vessels are severed.
With multiple tumors producing even more polyps, the patient is likely to take heavy vitals damage not just from the tumors and polyps but also from the scalpel as the blood vessels are severed. While it can be managed normally when only one or two tumors are present, the final wave of tumors these operations throw at the player (that involve 3 or 4 of these) would result in the patient taking lots of vital damage. Use of the Healing Touch is almost imperative to prevent the vitals from dropping too fast for the player to handle.
Once all 3 vessels on a tumor are cut, there is a limited time before the vessels regenerate. Thus, when working with multiple tumors, cut 2 of the vessels on each tumor first, then proceed to cut the remaining vessels to minimize the risk of the vessels, and any extracted tumors, from regenerating.
Tumors are visible during endoscopy since extraction is performed inside the organ.
First, inject fluids into the tumor using the syringe to make it protrude. Make sure you don't inject too much, or the vitals will take damage. When it protrudes, use the scalpel to start trimming off the tumor. Be careful with the scalpel as the vitals will start dropping fast while in use. At this point, the tumor will either fall off, allowing it to be immediately extracted using the forceps, or it will be trimmed similarly to a polyp.
Any polyps formed will require the snare to be positioned over them such that it can sever them from the surface of the organ. Then, they can be safely extracted with the forceps. Tumors that have been trimmed in a similar fashion are removed the same way.
Tumors are treated in several different forms during orthopedic surgery.
One such tumor will have a pink appearance and will require excision with a scalpel. Excise it carefully without straying too far from the guideline but stay close to the center line to get more of the chain accumulated. You may stop at any time but doing so will break the chain. After extracting one tumor, more, larger tumors will spawn and may even force the operating field to move forcing you to follow along. Sometime, much larger tumors of this type will be seen in the spinal cord. In that case, extraction of the tumor must be done in parts but the procedure is the same.
Another tumor type encountered is a soft spinal tumor which, as it is called, has a soft, elastic form. First an excision using a scalpel must be made. The tumor will then take up a spherical shape, where it can be extracted. Extraction with the forceps must be done slowly as too much force while pulling the tumor will tear the tumor and result in a miss.
The last tumor encountered is a bone tumor. The tumor itself weakens the bone structure around the tumor. With a chisel and hammer, align the chisel towards the guideline and strike the chisel with the hammer. Be careful as there may be space between the bone guideline and the cisel guideline. Keep the chisel still while you continue to chisel off the tumor from the bone. Afterwards replace the chiseled bone with synthetic bone.