I want to emphasize this: Surgeon Simulator 2 is not a surgical game. The first game was goofy and bizarre, requiring you to navigate through an intense night of open-heart surgery with clumsy keybindings and mouse clicks, even at the height of its ridiculousness, with anonymous doctors crushing ribs and replacing livers under the guise of medical institutions. In the sequel, however, we encounter the same challenges in a radically different context. The game completely erases the basic tenets of Surgeon Simulator and instead filters the franchise through the lens of crazy physics games like Goat Simulator and Octodad.

Maybe your patient needs a new liver, but that liver can only be found by completing rudimentary Mario-style jumping puzzles. Or perhaps he needs a new leg, but he must first rip off the old leg with his bare hands and hold it up to the scanner. The scanner, inexplicably, unlocks the corresponding door only when presented with human flesh, as if this hospital is owned and operated by Sander Cohen. As you are knee-deep in surgery in an abandoned corridor, you may hear over the intercom the tales of a vast conspiracy that is producing the eerily identical bodies you are operating on.

Bossa Studios has fleshed out Surgery Simulator's mechanics at every turn, deepening the challenges, coloring the margins, until it's a bona fide video game. No more memes.

The first thing you notice when you take control of Surgeon Simulator 2 is that your character is no longer anchored to the ground. They can run, jump, crouch and walk through vents. In the previous game, hand movements were mapped down to the tendons, but here some of that brutal unwieldiness is reduced. Left-click to close your grasp, right-click to rotate your wrist, and the shift key to pull your elbow back and forth; Surgeon Simulator 2 is as unwieldy as ever, but it doesn't try to throw you to the wolves like the original.

Surgeon Simulator 2's revamped doctor controls are very Portal-like. To win at each level, you must replace a patient's body part. They may have a bad kidney, a defective intestine, or in some cases, an entire head transplant. After identifying the disease, doctors go on a scavenger hunt to find the necessary body parts. The mechanics of the actual surgery - cutting out the heart without ruining everything - are not really important. Instead, the unique experience of "Surgeon Simulator 2" occurs when you know you need a new left arm, but you don't know where to find it.

These puzzles are generally well done. In one case, pulling a lever on the third floor of a hospital was intuitively horrifying as a spare leg slammed loudly onto the operating floor. Once you have the material, all you have to do is keep a steady hand.

Most of your experience with Surgeon Simulator 2 will probably be spent in the story mode, which consists of 11 missions. The player is a new student at a shabby "surgical training school," an enigmatic concept that aims to democratize surgical technology from the rich private school elite. The origins of the school are told by two voices over the intercom, like a system-shocking radio play, and become increasingly complex. There is not much meat on these bones, but if nothing else, the story will make one wonder if the right to perform surgery, no matter who you are, should be an unwavering natural law.

Although the campaign can be completed alone, "Surgeon Simulator 2" strongly encourages up to four players to play cooperatively at every turn, and players are assigned to a public party that can be matchmaking when the mission loads. I never took advantage of this option - this is not the kind of game you play with an indefinite number of people - but I completed about half the levels with a friend. The addition of a fellow doctor made everything more efficient. It's nice to have someone who has a new stomach ready to go when you take out the old one.

As is usual in Surgeon Simulator, however, it is the mishaps that will be most memorable. The harrowing havoc of a botched amputation is best experienced with a friend.

That said, I was somewhat disappointed that none of Surgeon Simulator 2's mainline missions fully exploit the mechanical potential of multiplayer. Adding more players does not make the levels more complex, and I think Bossa has left more exotic, Portal 2-like puzzle opportunities on the table. Trapped in a flooded room, with only one dumb friend to chance a rescue and he needs to replace his kidney in time, Bossa seems to have placed much of that responsibility on the powerful level creator, who can make anyone his own clockwork Surgeon Simulator contraption It seems that Bossa has placed much of that responsibility on a powerful level creator who can make his own clockwork Surgeon Simulator contraption. At the very least, a party of four can create a level that requires a party of four.

Nothing shows how far Surgeon Simulator has strayed from its original premise more than user-created material. The first custom level we launched provided a brief tutorial on how to bug out the game and allow doctors to fly; the second level played through an interpretation of the first act of Raiders of the Lost Ark: Ark of the Covenant. It was a video game about a surgical procedure.

This is just a fraction of what is possible. Create a strange game and you will be rewarded by a strange community.

Given all this, one wonders if the name "Surgeon Simulator" needed to be attached to this game. Bossa could have left out the blood transfusions and stomach pumps altogether and made a funny, smart puzzle game with no surgery at all. Still, the word "simulator" was part of the joke. It has never been as funny as it is now.