This operation isn’t going well. It was meant to be a ‘simple’ heart transplant. Take the old ticker out, pop in the new one. Easy. This isn’t brain surgery after all (well, not yet, at least). But what should be a routine procedure in the theatre turns into a bloodbath of Eli Roth-style proportions. We’ve smashed the poor patient’s ribcage open with a hammer and pulled their lungs right out their chest like fleshy luggage. Unfortunately, we’ve knocked the new heart on the floor, so we’ve popped in a nearby bottle of fizzy pop instead and casually flipped the rapidly perishing subject the bird with our gore-soaked fingers.

This is Surgeon Simulator CPR in a bloody, self-contained nutshell; it's a gore-soaked combination of unwieldy motion controls, sharp implements and a series of unfortunate patients too drugged to really put up much protest. There are no tutorials or helpful hints to urge you in the right direction, bar a few pointers on how to use the Joy-Con in the main menu. You’re just left with a patient ready to have their eyeballs pulled our or their brain replaced. It’s designed to be obtuse and unhelpful - that's part of the fun, after all. Are you really meant to smash someone’s skull open with a phone receiver? Of course not, but it’s certainly quicker than using a buzzsaw.

As you can probably imagine, there’s no clean or clinical way to perform these slapstick surgeries. You’re meant to cause untold chaos as you accidentally pull an eyeball out of its socket while moving in an ambulance or liquify the insides of an alien with a deadly fidget spinner. Your success is measured in whether you can ‘complete’ the operation before the patient's blood loss gets so out of control that they kick the bucket. You can pull out livers and lungs and throw them like rubbish from a handbag, just as long as you pull the old organ out and throw the new one in.

This being the latest iteration of a game from 2013, the Switch port benefits from a more well-rounded selection of missions. You can operate on brains and hearts, perform eye surgery, pull teeth and more, and when you add in environmental factors that up the difficulty factor - such as working in a moving ambulance where all your tools and jumbling about, or in zero-G where a bone saw floats in mid-air next to a scalpel - you’re getting far more bang for your buck than the first iteration of the game way back when.

The real question is, how well do the game’s motion controls - used in everything from DualShock 4 controllers to VR peripherals - stack up when channelled through the Switch Joy-Con? Well, they’re quite hit and miss, much in keeping with previous iterations. Outside of the original mouse and keyboard controls the game was originally envisioned with, Surgeon Simulator should, in principle, be a perfect fit for gyro-based tomfoolery, but too often it felt like we were fighting for control of our virtual arm by contorting our real-life limbs.

You use ‘LZ’ to lower your arm, raise the Joy-Con to elevate it, press ‘L’ to grip and the D-pad buttons to control individual fingers. It’s a system, when used with a mouse and keyboard, that offered precision if you could master the unwieldiness of its physics. But much like its port on PS4, Surgeon Simulator CPR’s hilarious medical violence soon gives way to abject frustration as you try and pry away a lung concealing another body part because your arm and fingers won’t cooperate properly. You can actually play with a Pro Controller or with the Joy-Con attached in handheld mode, and while this wasn’t the proper way this game was envisioned on Switch, it’s actually the most intuitive. Now you just use the analog sticks to move the arm and hand independently, and while it’s not a perfect like-for-like alternative, it does make completing each mission that bit more feasible.

We did find the clunky gyro controls a lot more enjoyable when played in co-op. This is, after all, one of the big selling points of the Switch port and having two limbs on-screen certainly makes for chaos as you and a friend split Joy-Con and create a co-operative bloodbath. As a couch-play experience, Surgeon Simulator CPR is a far more enjoyable proposition, since struggling to complete a procedure and murdering a patient with slapstick movements is far more fun with a friend sat next to you.

Conclusion

Surgeon Simulator CPR finally brings Bossa Studios’ slapstick medical ‘sim’ to Nintendo Switch, and while its use of Joy-Con motion controls is a little rough around the edges, they do make for some brilliant local co-op shenanigans. With plenty of patients to harm (sorry, we meant 'heal'), all manner of scenarios to contend with and plenty of hidden secrets to be found both in theatres and in the interactive menu, you’re at least getting one of the better versions of this veteran title.