Trauma Center was one of the more original early DS offerings and a surprise success. What's even more surprising, however, is the lack of copycat games following that success. By now, I expected to at least see one or two ER, House or Grey's Anatomy themed knockoffs; but that isn't the case. That alone makes Lifesigns: Surgical Unit unique and a fairly competent follow-up for anyone looking to get back into the hospital.

The presentation behind Lifesigns is great. Although most of the game is presented mostly through still images, the clean, anime style gives the game a nice strong feel. The limited animations are expressive and give the characters you come across personality, which is a great thing considering the amount of reading the game requires. That's right, there's no voicework at all, which means you'll have to read through all of the conversations - and there are a lot of them.

Both the soundtrack and sound effects are decent. They don't have quite the impact you'd want, though they're nothing that really hurt the game either.

In Lifesigns: Surgical Unit, you play as Tendo Dokuta, a second year intern at Seimei Medical University. Not only does he have to deal with the ins-and-outs of life at the hospital, but he's also struggling with a few personal problems. Not only is the hospital run by his estranged father, but he also has a monster crush on his mentor, Dr. Suzo Aso. Tendo's life outside the emergency room is the game's weakest aspect. Although it sounds interesting, Tendo's life is pretty bland. The plot unfolds through a series of conversations, which really just boils down to dragging a bunch of icons onto people until it pushes the story along. There's little weight to any of your decisions, which takes away from the experience. At least the characters are interesting.

You'll also play through a few mini-games. A few are story-related, such as playing air hockey or pushing a woman from in front of a bus. If a patient begins to flat line during a surgery, another mini-game pops up that involves using the shoulder buttons to try and revive the patient. The mini-games are nothing earth-shattering, though they do provide a fun distraction and are much more enjoyable that the endless conversations.

Although you'll go through Tendo's personal problems throughout the game, gameplay centers primarily on going through surgical procedures. Most scenarios begin with the introduction of a patient. You first talk to the patient in order to diagnose the problem; this is handled by selecting from a variety of tools, like a stethoscope, and using the touch screen. After making an initial diagnosis, you can then order x-rays or blood work to get a better idea about what is going on. Then it is off to the O.R. You'll manage most of the pre-op procedures, including speaking to the family and setting up an appointment with the anesthesiologist. To this extent, Lifesigns does a great job at giving you the complete "doctor" experience. Whereas Trauma Center was more about life in the Emergency Room, Lifesigns gives you a slightly different experience. The pacing is a little slower and methodical, which should appeal to anyone who was put off by Trauma Center's frantic gameplay.

On the other hand, the pre-op work can be a little tedious. Sometimes you just want to get into the operating room and start cutting - which isn't always the case since some tougher cases require a bit of Phoenix Wright-style investigation to figure out what is going on. Sometimes this can last almost an hour, which is way too much time to spend outside of the operating room, especially when what goes on inside the operating room is supposed to be at the center of gameplay. There are only a handful of surgeries in the game and they are spaced pretty far apart.

The actual operation is performed using the touch screen and surgical tools. Although Tendo is an intern, he's the one to perform the surgery. Surgeries are not as hectic as Trauma Center, but still pose a bit of a challenge. For one, every one is timed and the instructions aren't always clear. Sometimes your mentor of the patient will tell you one thing and mean something completely different. This is especially true when it comes to directions; when a patient says "To the left" they usually meant their left, and not the screen's left.

The actual operation isn't that challenging. You are handed the tool you are supposed to use and told exactly what to do (well, within reason... see the above paragraph). If things get confusing, you can press the shoulder buttons and activate the "concentration" ability that shows you exactly where to cut. This doesn't mean that every operation is a breeze - I left a nice trail of botched surgeries on my way through the hospital - but it isn't nearly as challenging as Trauma Center.

Nearly everything you do in Lifesigns: Surgical Unit involves the touch screen. Pre-op work involves things like listening with the stethoscope or doing hand examinations to find where things hurt. Once the x-rays come back, the stylus is used for circling areas that don't look right. During surgery, you'll have access to all of the normal tools of the trade as well as a few unique ones, like the electric scalpel. The overall response it good, though a few tools (like the electric scalpel) do require some practice. The only tool in the arsenal that doesn't work that well are the forceps; the response is okay, though it is sometimes hard to pick up smaller objects. You'll eventually snag it, but not before wasting valuable time.

The hospital layout appears on the bottom screen between missions. Various key locations show up on the map, as well as the people you'll have to talk to. Conversations involve dragging icons onto people, which will initiate a conversation with them. You also have access to an inventory screen which acts like the evidence in Phoenix Wright. This information is used when trying to piece together a diagnosis as well as trying to convince people to do things; otherwise you'll usually end up losing the patient and the game.

Lifesigns: Surgical Unit isn't a terribly bad game, though the slower pacing can hurt the game for players who are looking for something along the lines of Trauma Center. However, Lifesigns does offer a more complete doctor experience and gives the DS yet another unique experience.