Maybe it's just me, but I sigh every time I hear about a new DS 3D racing title with no dual-screen support, minimal touch-screen usage that just wishes it was on the meatier PSP. Likewise, the gratuitous touch-screen features in film licenses that are obviously just GBA conversions with knobs on never fails to irk me. So much for the DS being a 'Developer System' which opens up masses of creative opportunities for developers. Thankfully, some developers are starting to cop on. Enter Japanese developer Atlus, probably most famous in Europe for the entertaining Snowboard Kids on the Nintendo 64.

Titled Caduceus: Surgical Operation in Japan, this surgical sim is their attempt to shake up the DS' software catalogue. In doing so, they may have just have created a brand new genre of game; another surgical title, Tendo Doctor, is on the way in the not too distant future.

On paper, the idea is certainly original - using a variety of surgical instruments accessible via the touch-screen, you perform operations on patients with a variety of ailments, from cancerous tissue to serious cuts. In practise, it works wonderfully.I've played the E3 demo which was available for download at the show. Only two operations were playable, unfortunately, but from that you get a good taste for what this title is all about. You play inexperienced new doctor; Derek Stiles aged 26, whose trying to come to terms with a series of mysterious illnesses in the Los Angeles area. All the text in the demo is Japanese, but there is a quite a lot of dialogue involving nurses before each mission. Whether or not any exploration of the hospital or city is possible is unclear at present. When you do finally get into the OR, you are briefed on the patient's status and told to get to work. Faced with a scalpel, knife, antiseptic gel, ultrasound scanner and a host of other equipment, you begin.

Using the instruments is a real hoot. Spreading antiseptic gel across open wounds for example requires liberal stylus-strokes; whilst using the tweezers to extract foreign bodies from the skin calls for painstakingly careful movements. You'll also get the opportunity to administer adrenaline injections (flicking the stylus up to fill the syringe and down again to inject). Health is measured by the patient's heart rate, while a strict timer also ensures that you don't delay. Each action you take during the operation is graded, with the game awarding a final operation ranking at the end. Early reports from Japan suggest that the scoring system is often unfair; with perfect operations sometimes receiving low scores- hopefully the U.S and European versions will solve this.

It's one of those titles that just won't to appeal to everybody, but you probably already know if this is your kind of thing- rest assured, this looks like a well-executed game built on a great premise. Just a few gripes, though; why is it so difficult to apply bandages without killing the patient? (the humour of this situation sort of disappears after the fifteenth attempt). Also, I'm a little worried about how the developers will sustain the experience over the length of a full game; hopefully there will be enough meat in there to justify a purchase, although the grading system should add some longevity.

In fact, I think that this deserves a prompt sequel. How about some real scope for improvisation, Atlus? Granted, in the heat of the operating room the average doctor isn't going to be experimenting but it is a game after all, and there is a concern that the linearity of the game might count against it. And before you ask, no, you can't mutilate bodies Hannibal Lecter style in this game. I'd also love to see some voice recognition in the next game. Imagine saying '150cc's of adrenaline!' or even just 'Scalpel!' into your DS?

As it stands though, Trauma Centre: Under the Knife is definitely one to watch. We await with interest the finished English-language version.