Surgeon Simulator 2 features clever puzzles, co-op, creation tools, and even grosser physics

VIDEO: See the PC Gaming Show segment above.

Revealed at the PC Gaming Show, Surgeon Simulator 2 is more than just another game about a silly, bendy arm causing havoc in an operating theatre. It's something else entirely, cleverly branching out into other genres while retaining the gross, medically dubious physics comedy you'd expect from the series.

The original Surgeon Simulator, released in 2013, was a novelty physics game featuring the unruly, floppy arm of a dangerously clumsy surgeon. It was a hit, because at the time these games were still, well, a novelty. But now, in a world where Goat Simulator, I Am Bread, Octodad, and countless other slapstick 'simulators' exist, the joke has worn kinda thin.

Which is why I was delighted (and, honestly, surprised) to discover that Surgeon Simulator 2 has evolved into something much more interesting, inspired by puzzle games and immersive sims. Yeah, really. And now you can operate on poor old Bob, whose health is worse than ever, with up to four players. If you thought one of those flailing physics arms was chaotic, imagine four of them trying to perform the same delicate operation.

In Surgeon Simulator 2 there's a lot more of Bob to operate on, which means more ailments to cure. You can now walk freely around the operating theatre, viewing his body from any angle. In one scenario his leg has turned green and weird. I put years of imaginary medical school training to good use by grabbing his ankle and yanking it off. Then it's just a matter of finding a fresh, healthy leg and sticking it in its place.

So far, so Surgeon Simulator. But here's where things get interesting. The new game doesn't take place in one static operating theatre, but across many levels—some created by developer Bossa Studios, others by players. The theatre is often just one part of a larger map, with offices, labs, storage rooms, and other areas branching off from it. And it's here where the sequel's new puzzle-solving element comes into play.

No two levels are the same in Surgeon Simulator, but in this particular one I have to solve a series of fun, clever puzzles to get Bob a new leg, which involves accessing sealed-off rooms, finding keys to unlock doors, activating conveyor belts, and sneaking through vents. I certainly wasn't expecting to find traces of Portal and Deus Ex in, of all games, a Surgeon Simulator sequel. But this is 2020 and anything is possible.

Some levels are simple, with everything you need to complete an operation in easy reach. But others are incredibly complex, with lots of moving parts and connected, multi-stage puzzles to crack before you even think about getting your scrubs bloody. And, excitingly, all the levels designed by Bossa were made with the same easy-to-use tool players can use to make their own, which will give creators a huge amount of freedom and power.

Some levels will also be designed with co-op in mind, forcing players to work together to solve puzzles and gather the tools, drugs, and body parts needed for surgery. In the theatre itself, it's hilariously chaotic with four people running around, clattering into scenery, waving dangerous medical implements around, and making a mess of Bob's internal organs. The way each player's arm juts out in front of them is incredibly weird—and super funny, especially when they're fumbling with a scalpel. 

But it's not all about causing mayhem. To pass a multiplayer mission you will genuinely have to work together. Bob can bleed out and die, so if you slip with the bonesaw or something equally horrific, and the red stuff starts squirting out, a friend can grab a blood syringe and top him up. A scanner pointed at Bob will show you his current blood level, and how much he's losing, so it's always worth having one player keeping an eye on it.

I played Surgeon Simulator 2 for an hour, and I was blown away by how much new stuff is in it. What started as a one-joke novelty game has now, somehow, grown into an entire platform. Bossa reckons its creation tools are powerful enough that players will be able to create whole new games with it. I can only imagine what people will do with these tools once the game is released. But if you'd rather just play polished levels created by the developer, there will be plenty of those too.