Review: Lifesigns: Surgical Unit (Nintendo DS)


Lifesigns: Surgical Unit
Genre: Adventure/Puzzle
Developer: Spike
Publisher: Dreamcatcher
Release Date: 11/06/07

One thing you can say about the Nintendo DS is that the adventure genre has been given a Lazarus-style style resurrection on the system, and it is (mostly) awesome. From the Ace Attorney franchise (we can’t call it “the Phoenix Wright” franchise anymore because Capcom of Japan hates you, or, at least, me) to Hotel Dusk and beyond, the genre has made a strong impact on the console, and we as gamers are generally all the better for it. Of course, not all of the adventure games coming out for the system are “good” by any means (the Touch Detective games for instance), but one must take the good with the bad in all things.

And so too is it with Lifesigns: Surgical Unit, both in the “yay adventure games” and the “taking good with bad” sense. Lifesigns is actually the second game in the “Kenshuui Tendo Dokuta” series; the first, sadly, has remained in Japan, but such is life. More than a few people have made passing “ripoff” comparisons between Lifesigns and another DS surgery title, Trauma Center, but aside from the fact that Kenshuui Tendo Dokuta actually came out in Japan first, the comparisons aren’t really valid; Lifesigns is more akin to Phoenix Wright with some surgical mini-games thrown in (or alternatively, Grey’s Anatomy: The Game) than Trauma Center. Now, Trauma Center is a great game, no doubt about it, but it’s more directly focused on replicating a strategic action gameplay style; Lifesigns, by comparison, is an adventure game first and foremost, and thus appeals more to the Phoenix Wright crowd. That’s by no means a bad thing, of course, but you might want to know that before we move on.


The story of Lifesigns centers almost exclusively around Tendo Dokuta (who should probably actually be called Dokuta Tendo in the English translation, but whatever), an intern in his second year of training. You follow the various events in his life, from the introduction of a brand new intern to the hospital he works at all the way to Christmas of that year, as he interacts with the various people around him and whatnot. The story is very, VERY Japanese, so we’re clear here: the characters in the game all have their own affectations and odd quirks, and while PW fans will be right at home, someone looking for a game with more Americanized sensibilities will probably be put off, just so you know. That said, the storyline itself is actually really strong overall; it tugs at the heart strings when it has to (usually without feeling sappy or overbearing) and offers up plenty of humor where appropriate (especially during the third chapter… “Operation?”… heh), and in the end the story ends up being quite good. Two things keep it from being great, though; first, Lifesigns makes reference in more than a few cases to events from the first game, and while in MOST cases Lifesigns does a good job of saying “this happened in the first game, just so you know for later”, there are a few instances where you’re left scratching your head about what the characters are talking about (in Chapter 2, for example, Hikaru, Tendo’s sister, is brought up a few times; her history is explained in Chapter 3, but until then you’re left going “Who the hell is Hikaru?”). Also, while the actual translation of the game seems to have been done quite well, the proofreading and playtesting… not so much. Words are misspelled or grammatically incorrect and page breaks appear in the middle of a word in more than a few instances; this certainly isn’t game-breaking but it’s sloppy ESPECIALLY in this day and age. Even with the technical flaws and references to events in a game you can’t possibly play, the story in Lifesigns is a pretty good one, and fans of similar titles will like this perfectly fine.

I mean, I lol’d.

The presentation of Lifesigns is more good than bad, but not by much. The graphics are, as we’ve come to expect from this sort of game, all hand-drawn anime-style characters that animate as they speak along with static hand-drawn backgrounds, and they all look quite nice. The various surgeries also look good, and in many cases look more… “realistic”, shall we say, than in Trauma Center, though not in all cases. The various non-surgery mini-games, however, look like something you’d see hosted on Newgrounds most of the time; they’re not BAD so much as they are underwhelming, especially in comparison to the rest of the game. The audio is all cute midi music that is generally okay enough for what it is (though a couple of the tunes are certainly catchy), “pi-pi-pi” noises when people talk, which is what it is, and various sound effects during surgery, which sound vaguely accurate, but not spot on, though they certainly match up with the presentation of the game well enough.


The gameplay in Lifesigns is actually divided up into five different gameplay modes, each with their own neat elements and stumbling blocks. They are:

– the core adventure game mode, which is essentially identical to its contemporaries in all respects. You talk to characters to advance the plot as needed and present pieces of your records to move forward as is required. This part of the game is fundamentally no better or worse than its contemporaries; for the most part the game does a solid job of indicating to you what it is you’re supposed to be doing at any given time, though there are occasionally moments where you’ll have no idea what you’re supposed to do next… although these, thankfully, are infrequent. Most likely you’ll be able to get through these sections of the game with little to no assistance, depending on how much you can infer from the game itself.
– heart battles, which pop up once or twice per chapter and more or less function similarly to “Psyche-Lock” battles in the Phoenix Wright games: someone has a specific opinion or belief, and you have to break that down with evidence from your clinical log. None of them are terribly obtuse, either, and you should be able to get through most, if not all, of them with no assistance. There will occasionally be a point where you will be confused what piece of evidence to present next, but for the most part the game clues you in to what it is you’re expected to present (and you’ll often only have a few choices, anyway). If you DO fail the battles, however, the game continues onward; most of the time these battles have little overall effect on the game events, but on a couple of occasions they can change the ending of the chapter entirely, which gives you more incentive to properly proceed through them.
– examinations, which present you an injured patient and ask you to make a diagnosis. In these sections of the game, you will have to diagnose a patient’s malady by way of visual examinations, a stethoscope and palpitation (rubbing the patient with your hand). On one hand, examinations generally feel true to life on their own and, again, so long as you understand what you’re supposed to be doing in general they’re often challenging without being frustrating. However, the game doesn’t really explain what you’re supposed to be looking for in most respects, so you might, for instance, not realize you should be checking the person’s grip or pulse or what have you, which can lead to getting stuck in a few cases; the third examination I did left me stuck for an hour until I figured out you had to check his grip, for example. Once you understand how exams work, however, you’ll get into a routine of what to do and where to do it, and as a result, the exams become more like a game of Where’s Waldo than an exercise in removing hair follicles from your head in anger.

– surgeries, which are self-explanatory. Unlike Trauma Center, where you’re provided multiple tools at any given time, Doctor Tendo is provided only the tool he needs at the time. This is mostly because, unlike Trauma Center, where the gameplay is focused on a more action-oriented “do this in this amount of time while resolving all of the patient’s issues and keeping their heart-rate up” format, in Lifesigns the goal is speed and accuracy. The surgeries are generally more focused on doing each step correctly and quickly, and the pace is generally much more leisurely than in TC, focusing more on the steps of surgery than on managing everything at once. Also, instead of the game showing you specifically what it is you’re supposed to be doing at any given time, you’re simply presented with basic instructions and the body proper; however, if you need a guide you can “concentrate” to see the locations you’re supposed to cut/clamp/suture/whatever for a few seconds; thus, the game is less inclined to hold your hand every step of the way. The surgeries occasionally stumble at properly explaining to you what you’re supposed to be doing (how to I know the difference between the esophagus and the trachea just by looking at it?), but it’s actually really fun doing the surgeries, especially when you get to a point where you can do them successfully (and the game will advise you when you’ve done this thing).
– other assorted mini-games, which are more or less, as noted, silly little games you’d be likely to see hosted on a Flash website somewhere. For the most part it doesn’t matter if you succeed or fail at them, and they’re really only there to break up the talking with something to do, and in this respect they work well enough; they’re just not anything special or exciting.

So, yeah, there’s a lot to do. As noted, the heart battles, adventure sections and examinations are generally not too complex or frustrating (though they certainly have their obtuse moments…), and those who look back on the days of old PC adventure titles and cringe can breathe a sigh of relief here; these sections of the game are mostly balanced well and logical in their design. The surgeries, too, are generally well-balanced, and there will be a few cases where you’ll see a more complex version of an earlier surgery later in the game, as if the game is saying “okay, you did that, now let’s see what you learned”, which is actually kind of cool in certain respects. The mini-games are generally either very easy (the fruit collecting, air-hockey) or frustrating (fishing, takiyoki making), but with two exceptions the games have no bearing on the actual storyline itself (sadly, those two exceptions are the fishing and takiyoki making games…), so you don’t really have to be arsed to do well at them if you don’t want to.


Most of the chapters in Lifesigns are about one or two hours long, give or take, which is a blessing; the storylines of each chapter are fully fleshed out in each one without becoming boring, and you will find that the pace of the storytelling and plot advancement keeps you interested in what’s going to happen next. And once you’ve completed the game, it’s not over; each chapter has three different cinematic scenes to unlock based on certain things you accomplish, and you can unlock each surgery to play as often as you want as well, which should keep you coming back for a decent amount of time.

(Aside: I’ve noticed more than a few people are having trouble figuring out how to unlock all of the various cinematics in Lifesigns, and while I’m not uber-thrilled with Gamefaqs as a whole, I’d like to think I’m available to help as needed, so as an extra-special treat to you, the reader, here’s what you need to do to unlock the various epilogues in the game. These results have been culled from my own personal experience, translating a couple different Japanese websites, and reading through the message boards on Gamefaqs, so I hope they help. Please note: when I say an operation needs to be “a success”, that means you need to score over a certain amount of points (generally 25,000 points, or so it seems); you will know if you have done this thing because the game will say “The Operation was a success” in yellow text.

Episode 1:
Fail to convince Aioshi to let you operate on Kouchi.
Don’t complete Kouchi’s operation in less than three minutes.
Complete Kouchi’s operation in less than three minutes.

Episode 2:
Fail to convince Naoko not to slash her throat.
Complete Miina’s operation.
Succeed at Miina’s operation.

Episode 3:
Fail to convince Daichi that his daughter loves him (and see one of the weirdest typos in the game as a result).
Fail at the fishing mini-game, succeed at Yasushi’s operation.
Succeed at the fishing mini-game, succeed at Yasushi’s operations.

Episode 4:
Fail at takiyoki mini-game.
Complete Sora’s operation, succeed at takiyoki mini-game.
Succeed at Sora’s operation, succeed at takiyoki mini-game.

Episode 5:
Fail to save Sawai.
Give Miyuu the pig ( it’s recommended you go to the animated movie and win the air hockey game but it doesn’t seem to matter).
Give Miyuu the book of coupons (as above, but go to urban legend movie).
Give Miyuu anything else (stethoscope or matches).

Thanks to jp.wazap.com, Gamefaqs, and Alex Lucard for assistance in this thing. Bad translations and spelling are all my fault.)


For all of it’s replay value and novelty charms, however, Lifesigns isn’t terribly original. The format of the game is interesting for a surgery simulation sort of game, and the inspections are certainly unique, but the core gameplay essentially apes Phoenix Wright almost identically (get records, present them to move the story forward, repeat as needed). The concept of the game might also be novel, say, in Japan, but in America, ER, Scrubs and Grey’s Anatomy essentially make this game feel less like a unique concept and more like an inevitability. That’s not a bad thing, mind you; people who love those shows will adore Lifesigns and its way of doing things, but the game feels less like a unique proposition and more like multiple parts of other titles crammed together to make something unique by proxy; most of the components aren’t terribly new, though how the game works with them ends up being so by default.

Unless you have a strong distaste for the anime-styled adventure games that populate the DS, you really should have a blast with Lifesigns. It takes a little getting used to and it has more than its shares of technical flaws, that cannot be denied, but underneath these flaws lies an interesting and entertaining game that has lots of play and replay value and does things in new and interesting ways. The surgeries are well designed and amusing to play through, the characters are interesting and well-written, and the game will keep you coming back to it until you unlock almost everything the game has to offer (the 900,000 point sound test probably isn’t something everyone wants to unlock, though). As an adventure game, it does its job well; as a “doctor game” it’s believable and well thought out; and as a DS game it’s one of the better ones.

The Scores:
Story: 7/10
Graphics: 6/10
Sound: 6/10
Control/Gameplay: 7/10
Replayability: 7/10
Balance: 7/10
Originality: 5/10
Addictiveness: 7/10
Appeal: 7/10
Miscellaneous: 9/10

Overall Score: 6.8/10
Final Score: 7.0 (GOOD).

Short Attention Span Summary
Lifesigns: Surgical Unit has a strong pulse and good vitals all across the board. Some small genetic issues cause a couple potential long-term health issues, but a healthy personality and some entertaining gameplay features keep it from flatlining (and the writing is certainly better than all these horrible medical puns) and will keep it alive in your DS for a long time to come, should you give it a go.