Ever wanted to be a top surgeon but always felt that playing video games got in your way? Well, now you can realise your long-held dreams of theatre-room glory with the updated Trauma Centre on the Wii.

In Trauma Centre: Second Opinion, you take the role of a young surgeon who has just qualified for the position, a young man with great potential but his head firmly in the clouds as he tries to unsuccessfully mix the responsibility of a position where life and death are decided by a knife edge with his contrasting irresponsible attitude and arrogance.

You start off with a simple tutorial where you learn the basics of Wii-mote control in some fairly non-threatening situations. You will be introduced to suturing, cutting and antibiotics all as a matter of course, and it does the game great credit that it does not dwell too heavily on the minutiae of the tools, but instead the importance of their correct use. The nunchuk adds the ability to select these tools smoothly and quickly, without having to rely on any awkward menus.

The Wii-mote itself is well-suited to the role of surgeons knife, but the question is, are you? In too many Wii games it is not demanded of the player to act with too much precision and accuracy: here it is literally the difference between life and death, as a single error can cost you the entire mission. Eventually, though, precision becomes far easier to master, but the game will never forgive you for your mistakes.

Therein lies Trauma Centre's biggest problem: the learning curve is almost vertical at times and impossible to master without an obscene amount of patents, er, patience on the part of the player. A cut with a scalpel or a missed blockage leads to an immediate game over and requires you to restart the mission entirely, which is an extremely frustrating demand on the skills of the player when the mission is a multi-part operation requiring great skill at every stage. The rewards for success are an immense sense of self-satisfaction, but the punishment for failure is all-too-often difficult to tolerate.

Having never played the original game on the DS, I have no frame of reference for graphical or audio improvements; however I doubt very much that too much time and effort was put into augmenting either feature. The graphics are by necessity very basic, with organs and arteries all fairly well represented in a translucent, almost dream-like manner, glowing with an inner light at they pulsate in a satisfying manner. The Wii can almost certainly do better, but if the graphics were too complicated then the experience would be totally ruined, and also far too gory.

Sound-wise, the game really is quite below what I would expect for the home console. The musical score is increasingly repetitive and at times just boring. Using the same music for virtually every operation somewhat dulls the significance, and the developers could really have ramped up the tension by remarkable shifts in sound effects. As it is, the same squelches and slices are repeated ad naseum, and the character dialogue is just poor with "Dr Stiles!" and "Starting the operation!" being heard in almost every text conversation.

Had there been fully-animated interactions between the characters, then I feel that somehow the emotional investment in the whole story would be a lot greater on the part of the player. Static, albeit beautiful, cartoon images of the protagonists change only to express heightened emotions. It would have been a real coup if for example at one time or another, you actually watched a patient stumble into the OR in fully-animated-chest-clutching glory, but sadly it is not to be.

The story does take an interesting and important twist later on in the game after you have treated a number of predetermined patients. The story itself is quite interesting and finally does give you a better chance to care about the characters, but for some of you it will be too late as many players will have been so frustrated by the unforgiving nature of the gameplay that you will never make it that far. Which is something of a tragedy as the game really is worth staying with for the later levels when you are juggling a multitude of symptoms and problems all at the same time, giving you a real sense of frenetic energy and a great rush of happiness when you finally make it to the end.

Trauma Centre is hardly a lame duck, and nor is it a hopeless case by any stretch of the imagination. The developers should really be commended for their efforts to portray life-saving surgery in the digital world and the life-or-death situations surgeons face every day. But it is this strive for accuracy and the unforgiving gameplay that is the game's greatest weakness as it offers no comfort and no quarter to those who are less than entirely focused on the operation –and even for those people the situation can get quickly out of hand.

Overall, Trauma Centre is an excellent showcase for using the Wii-mote and nunchuck in tandem, as a game it falls short in many ways but not enough to discourage you from purchasing. Though it must be heavily stressed that this really is one fore the hardcore, even though the operations are split into short missions, these missions offer enough challenge individually as many other games do throughout their entire 20 hour lifespan.

The reason Trauma Centre scores so low in my opinion is because it just not offer enough opportunity for development to the player – you either learn the skills you need instantaneously or it's game over. Perhaps this is an allegory for life, but that's another article.