Atlus is one of Nintendo’s most creative third party developers. They make games that explore new ideas, experiment with new forms of control, and challenge gamers with nearly insurmountable difficulty. Back in 2005, Trauma Center: Under the Knife was just such a game. The concept of a surgery sim had been explored before, but the DS’s touch screen made it work for the first time. The story was pure anime drama, the gameplay was fast and addictive, and the game was punitively hard.

The Wii arrived on the scene nearly a year later, and Atlus wanted to show their support for the new platform. The console’s unique interface was a perfect fit for Trauma Center, and so Atlus reworked the first game for Wii, with the clever subtitle Second Opinion. The game was a sleeper hit launch title, doing more to validate the Wii’s bizarre controller than most other launch games, with the possible exception of Wii Sports. The hasty development schedule forced Second Opinion to be a remake, but it still stands as one of the best examples of how to remake a game.

Now, with more time and familiarity with the platform, Atlus has made a fully fledged sequel, titled Trauma Center: New Blood. New Blood fixes most of the problems caused by Second Opinion’s rushed development, and is one of the most satisfying sequels of 2007.

New Blood is named such because is introduces a whole new set of characters and a fresh story. It’s a good entry point for newcomers to the series, because you don’t have to be familiar with the previous games to understand New Blood’s plot. The game takes place a decade after Second Opinion, and centers on the exploits of Doctor Markus Vaughn, Valerie Blaylock and their helpful assistant Elena Salazar. The story starts in Alaska but quickly transitions to other locations, as Markus and Valerie are hired by Caduceus, the international research institute from the earlier games. The story is better written and more believable this time—while the surgeons are fighting a new super disease called Stigma, they perform far more realistic operations than Derek Stiles ever did. The GUILT operations in Second Opinion were fun at first, but they got repetitive and felt too much like an arcade game. Stigma shows up periodically in New Blood, but only when the story needs it to, which leaves you more time for pacemaker maintenance, transplants, first aide, and other realistic operations.

Second Opinion nailed Trauma Center’s controls for Wii, and New Blood doesn’t mess with what works. It keeps the quick tool selection on the Nunchuk stick, and the pointer still controls the surgery. The A button and B trigger operate the various tools, and for a couple they are pressed at the same time (for instance, as if you’re squeezing the forceps with your thumb and forefinger).

Context sensitive tools like the defibrillator paddles return, and are joined by new actions like heart massage (shock paddles are too dangerous for patients with pacemakers). Strangely, Atlus also included the ability to use only the Wii remote and select tools with the D pad. This was an okay addition I suppose, but playing with both the remote and Nunchuk is far more comfortable and efficient. Even if you decide to ditch the Nunchuk, the controls are mostly unchanged. Instead of jerking around with the controls, Atlus designed better operations around them.

In New Blood you’ll face the most strenuous operations the Trauma Center series can muster up. Gunshot wounds, shattered ribcages, torn ligaments, necrotic third degree burns and a double liver transplant are all waiting for you. “Marathon” surgeries return, with two new chapters requiring work on multiple patients. One chapter has the doctors in a field tent during a guerilla attack—you can expect to be picking ...