From Colonial Marines Wiki

Tools of the Trade

Image Name Function Improvised Equivalents
Scalpel.png Scalpel Used for cutting through flesh. Kitchen Knife

or Glass Shard

Laser scalpel basic.png Laser Scalpel Used for cutting through flesh, skips bleeder clamping. Basically acts as both a scalpel and a hemostat in one step during the initial incision. Can fail due to experimental nature. N/A
1Incision manager.png Incision Management System Used for cutting through flesh, skips bleeder clamping and organ rearranging. Basically acts as a scalpel, hemostat, and retractor in one step during the initial incision, then acts as a faster retractor afterwards. Failure proof unless patient is not under anesthetic. N/A
Hemostat.png Hemostat Used to stop bleeding during an operation, or to remove foreign and undesirable objects from a patient's body. Wirecutters or Cable Coil
Bone Setter.png Bone Setter Used for setting bones back into place. If used on a bone that is not broken then you will break it. Wrench
Bone-Gel.png Bone-Gel Used for repairing broken/shattered bones. Screwdriver
Retractor.png Retractor Used for re-arranging organs, and moving cut ribcages & skulls. Crowbar
Cautery.png Cautery Used for sealing incisions in a patients skin. Burns skin together. Cigarette or Lighter or Welder
Fixovein.png Fix-o-Vein Used for repairing veins and arteries. Cable Coil
Saw.png Circular Saw Used for cutting through bones. Hatchet
Advtraumakit.png Advanced Trauma Kit Used to patch all organs except for the brain and eyes. N/A


Surgery is a simple process with a series of steps. Once these steps are memorized it should become effortless and routine to perform. Keep in mind that once you have mastery over the basics, it's a good idea to aim to be as fast and efficient as possible due to the importance of recycling casualties back into the fight, or even preventing them from dying in the case of Foreign Object/Alien Embryo Removal

The first step is either applying anesthetic to the patient via the anesthetic tank and medical mask and turning on its internals (encourage your patient to put on the tank and mask, and turn the internals on as this is fastest and allows you to proceed with step two immediately), or using powerful painkillers like Oxycodone (recommended only for experienced surgeons). If you use painkillers, you must be careful to make sure that they aren't metabolized/depleted mid-surgery; use your medical scanner to monitor your patient's painkiller levels and redose as necessary. Note that even the most powerful painkillers feature a failure chance for steps taken during the actual surgery.

The second step is to prevent infection: wash your hands, spray yourself with Space Cleaner, or best of all, inject your patient with Spaceacillin effectively immunizing him from infection while it remains in his system (which will be awhile).

The third step is to place your patient on the surgical table (grab your patient, then click the table with your grabbing hand selected). If you must, you can improvise with a roller bed or even a table, but these improvised surfaces add a failure chance to each surgical step (a table's failure chance is higher).

Now that the preparations are done, you can begin with the actual surgery.

Most surgeries begin with a surgical incision into the tissue. The hemostat step can be saved for later in the surgery or skipped entirely at the cost of damaging your patient over time.

  • Open the incision.

Some surgeries require access to the organs behind the skull or ribcage.

  • Open the skull or ribcage.
    (Bone Saw->Retractor)
  • Close the skull or ribcage.
    (Retractor->Bone Gel)

All surgeries that begin with an incision must end in its cauterization.

  • Close the incision.

Surgery: Description: How to: Target Zones:
Bone Repair Surgery This surgery is used for mending broken bones and fractures.
  • Keep applying bonegel on the bonegel step until it's refused, Once you can't keep applying it, move on to the next step.
  • Open the incision.
  • Repair the bone.
    (Bone Gel->Bone Setter->Bone Gel
  • Close the incision.
Everywhere except mouth/eyes.
Internal Bleeding Surgery This surgery mends the torn/ripped arteries and veins within the body to stop internal bleeding.
  • Using quick-clot is usually faster than this surgery.
  • Open the incision.
  • Mend the artery.
  • Close the incision.
Everywhere except mouth/eyes.
Foreign Object/Alien Embryo Removal Removal of unknown objects, such as shrapnel, implants, or alien embryos from the body.
  • Alien embryos will always be in the chest behind the ribcage. Time is of the essence when removing them, and you must complete this surgery as quickly as possible; your patient will die instantly when it finishes gestating, resulting in the birth of an alien larva.
  • Open the incision.
  • Open the skull or ribcage if necessary .
    (Bone Saw->Retractor)
  • Fish out the foreign object.
  • Close the skull or ribcage if necessary.
    (Retractor->Bone Gel).
  • Close the incision
Everywhere except mouth/eyes.
Internal Organs Surgery Mending broken internal organs, excluding the eyes and brain.
  • Healing biological organs with peridaxon is usually faster than this surgery.
  • Open the incision.
  • Open the skull or ribcage if necessary.
    (Bone Saw->Retractor)
  • Repair the biological organ with a Trauma Kit, or the robotic organ with Nanopaste.
    (Advanced Trauma Kit/Nanopaste)
  • Close the skull or ribcage if necessary.
    (Retractor->Bone Gel)
  • Close the incision.
Groin, Chest.
Necrosis Treatment Surgery Treating necrosis by cutting away the necrotic tissues and treating the affected area.
  • Open the incision.
  • Excise necrotic tissue and heal the area.
    (Scalpel->Advanced Trauma Kit)
  • Close the incision.
Limbs: Legs, Arms, Hands, Feet.
Organ Removal/Transplantation Surgery Removing an organ from the body and transplanting a new organ.
  • Healing biological organs with peridaxon is usually faster than replacing them with this surgery.
  • Open the incision.
  • Open the skull or ribcage if necessary.
    (Bone Saw->Retractor).
  • Remove the old organ
  • Add and attach the new organ. Use the Trauma kit if biological, or the Nanopaste if robotic.
    (New Organ ->Fix-O-Vein->Advanced Trauma Kit/Nanopaste)
  • Close the skull or ribcage if necessary.
    (Retractor->Bone Gel)
  • Close the incision.
Groin, Chest, Head.
Brain Damage Surgery Fixing up the brain.
  • Using peridaxon or alkysine is usually faster than this surgery.
  • Open the incision.
  • Open the skull.
    (Bone Saw->Retractor)
  • Extract embedded bone chips from the brain until they are all removed.
  • Repair severe brain damage, if any.
  • Close the skull.
    (Retractor->Bone Gel)
  • Close the incision.
Facial Reconstruction Surgery This surgery fixes facial deformities caused by severe damage to the head. I.E. "Unknown as (name)" when speaking.
  • This surgery is of minimal priority and should only be done if you have literally nothing better to do. This is a combat operation, cosmetic surgery can wait.
  • Fix the facial deformities.
Amputation Removal of a limb.
  • Saw through the limb.
    (Bone Saw)
Limbs: Legs, Arms, Hands, Feet.
Limb Replacement Surgery The replacement of missing limbs with robotic ones. You can also reattach a robotic limb to just a hand or foot stump.
  • Seal the stump.
  • Attach the robotic limb.
    (Robotic Limb)
Limbs: Legs, Arms, Hands, Feet.
Head Reattachment Surgery The attachment of a previously missing head back onto the body.
  • Generally useless except in the case of repairing Synths.
  • Preparing the neck.
  • Attach the patients head.
Eye Surgery Mending the eyes to cure blindness and eye damage.
  • Using peridaxon or imidazoline is usually faster than this surgery.
  • Mend the eyes

Combining Surgeries

Very often people will come in with multiple problems at once. For instance, you might have a patient who has a fractured skull, brain damage, and shrapnel in their head. Performing three separate surgeries is very time consuming when other marines may be waiting. It is possible to condense the surgery down to one in such a manner:

  • Broken skull, brain damage, and head shrapnel removal surgery
  1. Scalpel Cut an incision while aiming with 'Help' intent at the head
  2. Hemostat Stop bleeders in the head
  3. Retractor Open up the incision for further surgery
  4. Bone Saw Cut through the skull
  5. Retractor Open up the skull
  6. Hemostat Here it gets a bit tricky, use a hemostat repeatedly to pull out bone chips and shrapnel until you get a message that nothing more can be found in the brain. Both types of removal can take several rounds or attempts.
  7. Fix-O-Vein Advanced Trauma Kit Use the FixOVein and Trauma Kit to repair hematomas and damage to the brain and eyes if necessary
  8. Use the Health Analyzer to check that the patient does not have brain damage! If the patient still has brain damage go back and use the hemostat and FixOVein more until the Analyzer shows no brain damage.
  9. Retractor Close the skull back up
  10. Bone Gel Use bone gel on the damaged bones in the skull
  11. Bone Setter Piece together the broken or fractured skull
  12. Bone Gel Add bone gel once more
  13. Cautery Seal up the incision
  14. Use the Health Analyzer again to see if the patient needs antibiotics or anti-toxins and administer them as needed

What about an infected marine with a broken chest, internal bleeding, and a ruptured lung? Here you'll want to use medication from the vendors in medbay in order to tackle the problems at hand.

  • Alien embryo removal, ruptured lung, and broken chest surgery (with a side of internal bleeding)
  1. First use one Quick-clot and one Dexalin Plus injectors to stop internal bleeding and to halt suffocation damage from the ruptured lung. While you can stop internal bleeding surgically, in the vast majority of cases a quick jab with Quick-clot is preferable. Keep a couple of Dex+ injector on hand to keep the patient from dying from the ruptured lung.
  2. Scalpel Make an incision quickly
  3. Retractor Ignore bleeders and rearrange organs. Removing the larva ASAP is the top priority right now
  4. Bone Saw Cut open the rib cage
  5. Retractor Separate the rib cage
  6. Hemostat Begin pulling out the alien embryo
  7. Advanced Trauma Kit Repair the ruptured lungs and any other damaged organs, note that a mechanical heart requires Nanopaste to fix
  8. Hemostat Now stem the bleeders with the hemostat
  9. Retractor Close up the rib cage
  10. Bone Gel One application of bone gel for the cut rib cage. Cut rib cages and skulls require one application of bone gel after they've been pushed back together.
  11. Bone Setter Set the broken bones in the chest
  12. Bone Gel An application for the set bones. In general remember that fixing a broken bone requires one application of bone gel before the setting and one after.
  13. Cautery Cauterize the incision, your patient should be recovering nicely now
  14. Again, use the Health Analyzer to double-check your work and to dispense spaceacillin or dylovene as needed

General Tips

  • Wash your hands to help reduce infection chance. A space cleaner bottle on yourself works too. Note that you can inject your patient with 5U of Spaceacillin to reliably immunize him from infection (until it is fully metabolized) and circumvent the need to wash your hands.
  • Anesthesia is important to successful surgery, make sure to put a mask on the patient's face, an anesthesia tank on their back, and turn their internals on.
  • If in a rush, you can give your patients 20U of Oxycodone for quick surgeries without anesthesia. You need to work quick though. A combination of Tramadol or Paracetamol and Inaprovaline can work well too while giving you more time. 5U of Chloral Hydrate is highly effective and fast. Do not use Chloral Hydrate excessively as it is toxic. Note that every form of anesthetic other than the anesthetic tank has a chance of causing your patient to flinch during the surgery.
  • Patients can often times tell you where they need surgery if an advance scanner is not available.
  • Triage cases properly, alien embryo cases and lung ruptures take priority over brain damage cases which in turn take priority over simple bone fractures in limbs.
  • Internal organ damage can oftentimes be fixed with Peridaxon turning some surgeries into simpler, faster bone repair surgeries.
  • Use the Health Analyzer to check for brain damage during brain surgery to confirm that you've fixed everything.
  • Use the Health Analyzer to confirm that a patient's bone fractures are all gone after performing all required bone repair surgeries.
  • Use the Health Analyzer to check for post-op infection that should be treated with spaceacillin.
  • If no other options are available, roller beds and tables can be used to perform surgery. These cause surgical steps to have a failure chance unfortunately.
  • A prototype medical device known as an incision management system or IMS, can often be found planetside; have the marines retrieve it if you can. The IMS acts to create and spread an incision and clamp bleeders simultaneously.
  • Infected wound detected in subject [Insert Location Here]. Disinfection of wounds recommended means that the patient has a infected wound that needs to be treated with gauze/advanced brute kit, surgery and spaceacillin won't work at all.
  • If you don't have proper surgical tools on hand you can use their ghetto/improvised equivalents per the table above if necessary. Improvised tools generally have a fairly high failure chance starting at about 25%. This failure chance is cumulative and multiplicative with the failure chance for not having a proper operating bed/surface.