Surgery needs a buff/rework badly

[JaxelT]

It's incredibly risky right now even with advanced tools. My surgeon, with a skill of 19, installing a bionic foot on a patient, sober, in a brightly lit room, on a medical bed, with a vitals monitor, using herbal medicine, removed his heart and instantly killed him. It's simply far too random when you fail and you fail too often. There really should not be any way for someone that skilled operating under those conditions to fuck up that badly, it strongly disincentivizes surgery because you're at the whim of the RNG to instantly lose a colonist. I could understand if using herbal medicine led to him getting an infection or something, even if the operation was successful (infections would actually be a fantastic penalty for failed surgery on all levels) but the "removing random body parts on a failure" thing, while amusing the first couple times, is just stupid unless the surgeon is drunk. Please rework the surgery failure system ASAP.

[Peng Qi]

Yeah, imagine if surgery were this dangerous in real life. Nobody would risk it!

Amputations were almost always successful before the advent of modern medicine. That means an amputation with herbal medicine and a moderate-skill doctor and no hospital bed probably ought to have a near-100% success rate on limb amputations. Heart transplants should be somewhat risky with modern tools, but with future tools should be pretty safe.

[JaxelT]

For that matter, losing a liver or a heart or both kidneys should not be immediately fatal. They should rapidly lose health as a result of having Blood Filtration or what have you at 0%, giving you a chance to prep emergency surgery to replace the organ if you have one available.

[Kraven Kor]

Yeah, imagine if surgery were this dangerous in real life. Nobody would risk it!

Amputations were almost always successful before the advent of modern medicine. That means an amputation with herbal medicine and a moderate-skill doctor and no hospital bed probably ought to have a near-100% success rate on limb amputations. Heart transplants should be somewhat risky with modern tools, but with future tools should be pretty safe.

Eh, civil war doctors would probably disagree with you. 

Gangrene killed more men than bullets alone.

That said, I support making surgery less risky once you have good infrastructure and supplies.

[lorebot]

For that matter, losing a liver or a heart or both kidneys should not be immediately fatal. They should rapidly lose health as a result of having Blood Filtration or what have you at 0%, giving you a chance to prep emergency surgery to replace the organ if you have one available.

I don't know...having your heart removed is pretty fatal...unless you're hooked up to a machine that will pump your blood you'd die within a minute or two.

Losing both kidneys or your liver isn't instant death, you'd die pretty quickly over the next couple hours though without some serious medical intervention. You can live without your kidneys given you get dialysis regularly (ie 4 hours of treatment 3-4 times a week) and it's possible to live without a liver for a day or two given proper conditions and treatment, unlike the kidneys it's far too important to your body to survive without it for any longer than that though given current medical science.

Likewise you could conceivably live without lungs if you were hooked up to some device that could keep your blood oxygenated but that's far beyond current medical science.

[lorebot]

Eh, civil war doctors would probably disagree with you. 

Gangrene killed more men than bullets alone.

That said, I support making surgery less risky once you have good infrastructure and supplies.

This was only the case because of the conditions under which surgery was performed. In most cases battlefield surgery in that era was done in a tent without any sort of sterile environment, and often without even sterile tools. There were simply far too many wounded to keep up with and they didn't have time to take even basic precautions at most battles. The weather and environments didn't help matters much. Most of the places that saw battle during the conflict were in the south where it was humid and hot which only made it easier for infections to set in.

[Peng Qi]

Eh, civil war doctors would probably disagree with you. 

Gangrene killed more men than bullets alone.

That said, I support making surgery less risky once you have good infrastructure and supplies.

This was only the case because of the conditions under which surgery was performed. In most cases battlefield surgery in that era was done in a tent without any sort of sterile environment, and often without even sterile tools. There were simply far too many wounded to keep up with and they didn't have time to take even basic precautions at most battles. The weather and environments didn't help matters much. Most of the places that saw battle during the conflict were in the south where it was humid and hot which only made it easier for infections to set in.

Furthermore, even then it wasn't the amputation that killed the patient. It was the gangrene. Maybe amputations should be possible without medicine but have a high chance of a second infection.

[Schwartz]

Yep, there should be some safety net. Like being able to fix up a botched surgery with another investment of medicine and time. And not losing your expensive bionic parts to 'minor' failures, that one really irks me the most. The system as it is now heavily encourages savescumming and that's not fun for anyone.

[lorebot]

Yep, there should be some safety net. Like being able to fix up a botched surgery with another investment of medicine and time. And not losing your expensive bionic parts to 'minor' failures, that one really irks me the most. The system as it is now heavily encourages savescumming and that's not fun for anyone.

Losing prosthetics in surgery mistakes drives me insane. What'd they do? Break it in half before they removed the guy's kidney instead of attaching the prosthetic? Even if that's the case you can't tell me the prosthetic couldn't be repaired somehow...

[JonoRig]

Mỹ two biggest issues definitely are losing the prosthetic every single time during failed surgery, and also the ridiculousness that you're operating on someone's toe... Oops his heart popped out, lost his head a a thumb... Why we're you even near those areas? And how did you accidently decapitate them with a scapel?

[Goo Poni]

Because Tynan subscribes to the Dwarf Fortress style of Fun.

[Grishnerf]

, using herbal medicine,

use normal medicine.

[chaotix14]

Because Tynan subscribes to the Dwarf Fortress style of Fun.

At least in DF it makes some amount of sense, because the dwarves are generally shit-faced drunk 24/7.

[mumblemumble]

Yeah, imagine if surgery were this dangerous in real life. Nobody would risk it!

Amputations were almost always successful before the advent of modern medicine. That means an amputation with herbal medicine and a moderate-skill doctor and no hospital bed probably ought to have a near-100% success rate on limb amputations. Heart transplants should be somewhat risky with modern tools, but with future tools should be pretty safe.

depends,  in ww1 trenches soldiers would threaten to kill doctors over amputations,  as it would often be fatal from bleeding,  ect.

This said,  i like the idea of a more logical failure,  like infection,  severe bleeding,  scars in the local area,  ect. Surgery failures now feel like a 1 in 10 chance for a stray bullet to enter the room from a random caliber.

[cultist]

, using herbal medicine,

use normal medicine.

I'm also confused by this. If you're doing actual surgery and not just patching up wounds, you should use the best medicine available, if you care about the pawn. Herbal medicine should only be used for normal wounds, non-life threatening diseases, etc.