Nintedo World Report writes: "The original Trauma Center: Under the Knife is widely held as one of the best early Nintendo DS games. Fans and critics praised its interesting use of the touch screen, dramatic storyline, and very challenging gameplay. Atlus must have liked it too, because they converted the game into a Wii launch title with pointer-based controls and some extra missions. After 2007's follow-up, Trauma Center: New Blood, arrived with voice-acting and cooperative multiplayer, it looked like the series had found a permanent new home on Wii. It came as a surprise to many fans when Atlus announced yet another sequel just a couple of months after New Blood's release, this one returning to the DS.
Under the Knife 2 takes place three years after the original game (a.k.a. Second Opinion), and Dr. Derek Stiles is once again the main character. While on a medical expedition to the fictional Republic of Costariga, he meets a young (and rather androgynous) native doctor, Adel Tulba, who quickly becomes Derek's apprentice. They soon find themselves embroiled in the deadly after-effects of the GUILT epidemic that Dr. Stiles conquered in the first game. The story is once again told through lengthy slideshows before and after each operation. Due to the limitations of the DS storage medium, this game reverts to text-only dialogue."