Surgical Primer

Introduction to Surgery

Welcome to the wonderful world of surgery in Shadowrun:Denver. The aim of this primer is to assist you in learning to do surgery queues for whatever needs may come. From the simple datajack install to the full-borg someone requests. Lets start our trip with the basics required to be a medical professional in game.


As a medical type person in-game, there are a few basic things you'll need in order to do any work. We'll go over those things now.


This is your bread and butter. The skill that will do just about anything medical related in the game. You can specialize it in several fields. As a doctor, this skill is required to be at least a 4 for you to do proper surgeries.

Cybertechnology Implantation: Used for implant surgery of cybernetic items.
Extended Care: Used when a patient has an extended stay for healing. Most Runners don't opt for this.
First Aid: The basic lifesaving skill, from staunching a bloody cut to the Heimlich maneuver. Runners use this a lot.
Magical Health: A new specialization used for extended care of Awakened patients. Typically used by Awakened medics and uses less invasive methods of healing.
Organ culture and Growth: Used for growing organic bodyparts. Not something most shadowdocs take.
Surgery: This deals with all surgical areas not included in Cybertechnology or Transimplant.
Transimplant Surgery: Used for Bioware surgery or replacement bodyparts.


Cybernetics: This specialization includes knowledge of cybertechnology that incorporates computerized systems, whether hardware or software. It focuses on the neural interface between such devices and the brain and nervous system, as well as datalinks to other devices.
Computer (Cybernetics) B/R: This skill is called upon by implant surgeons repairing headware, skillwires, matrixware, riggerware and other computerized systems.


Cybertechnology: This specialization of electronics deals with cyberware that incorporates electronics, especially senseware, cyberlimbs, smartlinks and other powered devices.
Electronics (Cybertechnology) B/R: This skill handles the construction, maintenance and repair of electronic cyberware.


This skill is used for diagnosis of medical problems as well as planning surgical procedures. A doctor with no specialization in Medicine is considered a general practitioner. As a doctor, this skill is required to be at least a 4 for you to do proper surgeries.


A secondary knowskill, for those that wish to keep their Awakened patients as comfortable as possible without the use of harsh modern chemicals.

Medical Gear

Medkit To do any medical work, you need a few basic tools. The most basic of these are Medkits. Good for patching someone up, or keeping them alive until they can be brought to a proper clinic. Don't expect to do any surgery with one of these.
Slap Patches The next best thing to a medkit, though many have side effects. They are easier to carry than a medkit, and certainly easier to apply, but usualy left to those without any medical skills to get them through until a real doc can get to them.
Medicine Bag A custom bit of gear made just for Denver. This can be used to help heal the magicaly Awakened without the issues a medkit might introduce to their delicate systems. (Found at +info gear custom misc Medicinebag)
Clinics The meat and potato's of any Shadowdoc. You need one of these to do any work at all without renting anothers clinic. Most people will start out with a general clinic, or perhaps an upgraded specialty clinic dealing with just one aspect. The choice is up to you and what you want to play. Just remember, in order to use a clinic, you need a building to set it up in, which can be hard to achieve when you are fresh out of Char-gen.
Micro-vision This is a cybernetic upgrade, that allows you to zoom into something with great detail at short distances. Worth getting as they give you beneficial modifiers for your surgeries, and even on electronics and computer work.

The Rules!

From here, it's mostly a matter of number crunching to get the TN you need to do a surgery successfully. There are a few charts
The First thing (after having a clinic available, of course) that you need to do is work up a profile of the prospective patient.


A Profile is probably the easiest part of the entire process. It is at TN4, with a base time of 48hrs using your Medicine skill. Your patient will have to be available for one quarter of that time, or base 12 hours. This simple step keeps you from having to add another +1 to your surgery TN. You can use the rating of your clinic as comp dice for the roll. Once this step is done, you can move on to…

Surgical Plan

Now this step is completely optional for the most part. You don't need a surgical plan at all for Basic and Alpha grade surgeries and don't take any TN penalties for not having one. Once you hit Beta and better though, you will need to make one up to avoid the +1 TN penalty for not having a plan.

But lets say you want a plan, and want to add in some positive options. Lets go over that. First, determine the type of surgery it is going to be; Cosmetic, Cybernetic or Bioware. These all affect the Base TN. For this example lets with with Alpha Grade cyber install, with two positive options.

The Base TN right now is 4. We added in two Essence reduction options, so we add +1 for each of those, giving us a TN of 6. The base time for a Cyber surgery is 72 hours, alphaware gives us a x2 modifier, and each Reduction option gives us another x2, for a total of x6. So, total time is now at 432 hours base.

Base time 72hrs(cyber) x 6(2 for alpha, 4 for options)=432hrs

So, at TN6, we roll our Medicine skill again, along with compdice from the clinics rating. Let us guestimate you will get an average of 4 successes(baring karma rerolls). We take that total time and divide by the successes, in this case getting 108hrs. That is how long it will take to make this plan. We then divide that by 8 (the average hours a person will work in a day, and still have time to run), and makes it about 13.5 days working time to finish. So two weeks to get a medical plan finished. Yes, it is a lot of time to spend, but you make it up by charging someone big Nuyen.

As an aside, you can get a medical group together to all work on the plan to reduce the time, but that's a bit of an advanced option, so won't go into it in this starter.


Now you have a medical plan ready, got all your gear setup and the 'ware is ready to be installed. What do you do now? A bit of number crunching. On the MU, type in '+info surgery mod' and that will bring up the basic list of all the TN modifiers there are. For now, You have an Rating 3 Alpha clinic, so you can install that piece of Alphaware you did the surgical plan for.

The Base TN for cyber installs is 4.
The patient currently has 1 point of bioware installed, and their essence is above 2. What this tells you is that you already have a +1TN thanks to the bioware the person has.
This is Alphaware, so you have +1 TN for that.
You have both a medical profile and Surgical plan, so no negative TNs for that.
You have a clinic in good conditions, giving you a -1TN.
They are not awakened, so no TN modifier for that.
No assistants for this surgery, so no TN modifier for that.
You probably have Micro-vision, so you gain a -2TN for the surgery.

With all those Modifiers, you end up with TN3 (TN2 is the lowest you can go). The surgery will take 3 hours (hours equal the TN) base.

You must Pick 2 Negative options (done with the surgical plan, but also with any surgery you do). These are negated as you gain successes on your Biotech test.

In addition to this, you have two Positive options, but their TN is figured in seperately from the main TN. The Essence Reduction option has +2 Threshold modifier, which means it adds +2 to the TN for each one, with a special note for these that the modifier is added together all at once.

For this part, you need to make a list. First you list your Negative options, then your positive options so it will look something like this:

Options Success # TN
Negative option 1 First Success 3
Negative Option 2 Second Success 3
Successful Surgery Third Success 3
First Pos Option Fourth Success 7
Second Pos Option Fifth Success 7

This is a Biotech (or specialization) roll, with the clinics rating as compdice. The Roll is an 'open' roll, meaning no TN is specific when you roll. You then take success from that and make rerolls as needed, going down the list that was made.

You need three 3's, and two 7's to successfully pull this surgery off. As long as you get at least the first three successes on the list, the surgery is considered successful, and you can move up to the more complicated procedures. After the two 7's are covered, any leftover 3's can be used to reduce the time of the surgery from its base of 3 hours.

The Finish!

So, you've made the rolls and successfully completed the surgery. With all that out of the way, at the end of the queue you submitted to start this whole shebang, make sure you list how long it'll take you (either base hours or modifed by successes) as well as the modified essence rating of the cyberware (calculated as show here

So that's about it! There are more advanced things that can be done, but save that for another time. This will get you started in the grand world of Shadowdoctors!


These rules can be applied to doing multiple surgeries as well. Just keep in mind that each surgery requires its own Medical Plan (if you are doing one), and its own surgery test. And each surgery beyond the first (in the same day) gains a +1TN for each surgery you do. This includes stuff like multiple items in a single piece of ware(no, they can't be all done at once, sorry). Also, If you upgrade the Grade of a limb, none of the gear inside gets upgraded unless you buy the parts to do those as well and make the surgery rolls for it!

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