X missions

The X or Extreme missions are a special set of operations that are unlocked in Trauma Center games after completing all of the standard missions on any difficulty. These missions always are focused around a single GUILT or Stigma strain that is exceptionally more powerful than when encountered on any regular mission. These missions are listed under the "Extreme" difficulty.

Major Differences - GUILT

Kyriaki

• Kyriaki attack with much higher frequency
• Lacerations caused will deal much more damage
• More Kyriaki bodies will be present
• If on Under the Knife 2: the number of Kyriaki pupas will increase each time the Queen Kyriaki hides into the organ after it is lasered. (2,2,3,3,4,5)
• Vitals will drop much faster
• Increased HP

Deftera

• Tumors will drop vitals much faster
• Tumors will spawn polyps faster
• Deftera will cause more vital damage when two of the same color Deftera combine
• Deftera will cause hemorrhaging (Second Opinion only)

Triti

• Triti layout will be much less conducive to removal
• Purple sections will deal dramatically more damage
• Thorns will vaporize more often
• Vapor will move faster

Tetarti

• Diverticula will grow faster
• Tetarti will move faster
• Less time to inject all three with antigen
• Poison mist will do more damage

Pempti

• There will be less time between each attack
• Attacking bodies will be more resilient to damage
• Polyps and lacerations will deal more damage
• Pempti sometimes sends out two waves of attacking bodies in succession
• In Under the Knife 2, Pempti core resilience will be slightly unevenly distributed

Paraskevi

• Vitals will be maxed at 50 (Second Opinion only)
• Dissecting a Paraskevi body will deal 30 damage (Second Opinion only)
• Paraskevi will attempt to move to next organ earlier

Savato

• Nest will turn red significantly faster
• Savato will spawn more mini-Savato bodies with its attacks
• Attacks will occur with higher frequency
• Laser will need to be applied much longer than normal during the second phase
• Mutated Savato

Major Differences - Stigma

Cheir

• More Cheir bodies will attack at once
• Cheir will attempt to create large lacerations and tumors, as well as the normal lacerations

Soma

• Small tissues will harden faster
• Soma will spawn more red and blue polyps
• All polyps and hardened tissue will deal significantly more damage

Ops

• Smaller bodies will fire nutrients more frequently
• Tumors will deal massive damage if detonated
• Ops will take more laser hits to defeat
• Tumors spawn much more often
• Ops cores splitting after to 2 laser incinerations

Onyx

• Onyx will not wait as long to attack (You've got approximately 7 seconds to find Onyx)
• Letting Onyx attack will deal 70 vital damage
• Venom in third phase will drain vitals much faster

Brachion

• Venom will move through the feelers much more quickly
• If the venom is allowed to reach the feelers, it will deal much more damage
• Feelers need to be removed an additional time
• There are 21 graplers to be extracted instead of 14 (3,3,3,4,4,4)

Cardia

• Red tiles will reduce max vitals by much more
• Cardia will attempt to detonate tumors in the second phase more quickly
• More laser hits will be required to finish it off

Major Differences - Neo-GUILT

Nous

• Amount of tumors will increase (Last stand is 6 spore tumors, instead of 5)
• Smaller window of time to treat and remove tumors before Nous dives
• Instead of 30 vital loss per tumor when a wrong tumor is touched, the vitals drop by 65 per tumor

Bythos

• More lacerations at the pre-GUILT stage (8 instead of 4)
• Core has to be removed 6 times
• Core spores move faster
• Greater vital damage if a spore or shard is touched (50 vital damage)

Sige

• Hematocelae are created more frequently
• Sige will move faster
• More clones created by Sige
• Pus is formed very fast and will cause severe damage

Aletheia

• Vitals will drop much faster
• Smaller window of time to inject antibiotic into Aletheia
• Blood veins will alternate faster