The only downside to last year's Trauma Center: Second Opinion was that it was mostly a port of the DS game. While the original was great and the Wii-based controls added something new, the experience wasn't all that new. Trauma Center: New Blood is Atlus' third game in the surprisingly popular series and easily the best of the series.

The first two games placed little focus on visuals, and New Blood follows suit. If you're the type who can't stand the sight of blood or any type of medical procedure, don't let the fact that this is a surgery-based simulator put you off. Most of the emphasis seems to be on making the game easy to play. The game doesn't go for realism; so the vital organ you're working on only vaguely looks like the body part it is supposed to represent. There's blood, but it is really just a cloud of red splatter.

Anime-styled characters pop up between surgeries to push the story along. As with previous games, they aren't animated, but they do change expressions to go along with the text. The accompanying voicework is good, though it is wasted on really bad, over-the-top dialogue. The funny thing is, it is so well crafted and worded, that I could never figure out if it was meant to be as bad as it is, or if it just dumb luck. Although bad, it shouldn't put off many players, especially those who watch anime since they're already accustomed to characters summoning the stars, ancestors and a long-dead pet gerbil, Patches, before performing any action.

Trauma Center: New Blood isn't a direct sequel to the original game, though it does take place in the same game world. This time around you play as Valerie Blaylock and Markus Vaughn, two surgeons from a small Alaskan town who are thrown into a variety of medical emergencies as well as having to face down a new disease called "Stigma". Oh... there's a talking dog...

Anyone familiar with the previous two games should feel right at home with New Blood since it follows the same basic setup. But, for those who finally managed to get their hands on an elusive Wii, here's a breakdown: Trauma Center is a surgery simulation where players take the role of one of the two doctors and go through the day-to-day routines of a surgeon. Each surgery begins with a quick diagnosis, followed by the procedure. A variety of tools are available during each surgery and selected with the Nunchuk. Once the tool is selected, players guide it using the Wii-mote or activate it using a few simple button combinations. Though the process sounds complicated, it makes a lot of sense when seen in action.

Most of your time is spent performing routine procedures like fixing breaks, removing bullets and healing other common ailments. Once the Stigma virus is introduced, the game gets really crazy. Stigma is an evolving virus that can take many forms, each with its own unique conditions. One variation might be a flesh-eating tumor while another moves through a patient's body and lacerates their vital organs.

The only new addition is co-op play. Though it was something I wanted to see in Second Opinion, the idea of two surgeons working together didn't sound that enticing the more I thought about it. If you can manage to find a partner, it is a lot of fun if both players can work together. Even with two people working together, New Blood is still extremely challenging.

Although most surgeries make sense and are fun, Trauma Center: New Blood isn't immediately accessible to everyone. After the first few surgeries, New Blood gets incredibly difficult, even on Easy. Goals are typically clear, though you aren't always told exactly what you need to know. I'm not a medical professional, but I'm pretty sure most doctors have a good idea about what they're about to do before they start rummaging around in a patient's body. Though you typically know the general idea about why you're cutting your patient up, you always have all of the right information, resulting in a few silly, and avoidable, mistakes.

Other mistakes are a direct result of some surgeries being way too sensitive. One mistake is usually enough to put the entire procedure in jeopardy. Though there are ways to try and remedy the situation, most of time you'll end up having to repeat the entire thing. This becomes especially frustrating when the mistakes shouldn't have an affect on the patient anyway. To make matters worse, some surgeries are really long.

The control scheme from the first Wii version is kept largely intact with Trauma Center: New Blood, so old timers should fall right in-step while newer players who missed out the first time (shame on you) will take a little longer to hone their craft. Your main instrument is the Wii-mote, which is a bit of a Swiss Army knife as far as tools are concerned. All of the tool types are selected by using the Nunchuk. This is the area that will take newcomers the longest time to get used to; but once you've lost a few patients because of your incompetence as a surgeon (failure is the game's BEST motivator), you'll learn quickly.

Once a tool is selected, you guide it using the Wii-mote as a pointer in conjunction with various buttons combinations. Surgery has a bit of "arcade" flair despite the game's place as a simulator. Your performance as a doctor is graded by scores and combos since just saving someone's life isn't enough apparently.

Though the two surgeons each use the same tools during each procedure, each has their own special "Healing Touch" abilities. When activated, Valerie's patients don't feel pain or take damage for a short time while Markus is able to slow down time. Both of these skills are incredibly useful and help to balance out some of the difficulty.

As frustrating as some surgeries get, the high difficulty level adds a little more to the overall enjoyment. It's rare that a game actually makes you feel like you've really accomplished something, which is exactly why Trauma Center: New Blood works as a game. Some players may be put off by the dialogue and difficulty, but in the end, it is worth it.