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Old 09-04-2017, 09:24 PM   #1
Wayne
 
Join Date: Jul 2005
Location: Geelong, Australia
Default Surgery - How does it work?

Hi,

I'm a bit confused about Surgery in GURPS.

I understand how physician works (get HP back per day etc)...

But there doesn't appear to be a rule saying successful surgery gives back n hit points.

It can cause damage on a failure, stabilise a mortal wound, repair a crippling injury, but there doesn't appear to be a benefit on hit points!

Any thoughts please?

Thanks,

Wayne
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Old 09-04-2017, 09:33 PM   #2
Refplace
 
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Default Re: Surgery - How does it work?

Surgery does not giveback HP.
In fact it really should subtract HP.
This is the skill you would use to save a life by pulling out a bullet, possibly setting a limb (at a penalty, IMHO), removing a tumor or organ, etc.
After surgical procedure you use Physician to speed the recovery.
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Old 09-04-2017, 09:37 PM   #3
clu2415
 
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Default Re: Surgery - How does it work?

It works like in real life. Surgery doesn't heal you; it is cutting open the body to repair an issue that isn't letting your body do its work. It's up to your body to do the actual healing.
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Old 09-04-2017, 09:38 PM   #4
Wayne
 
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Default Re: Surgery - How does it work?

Quote:
Originally Posted by Refplace View Post
Surgery does not giveback HP.
In fact it really should subtract HP.
This is the skill you would use to save a life by pulling out a bullet, possibly setting a limb (at a penalty, IMHO), removing a tumor or organ, etc.
After surgical procedure you use Physician to speed the recovery.
So doing surgery to repair a massive hole does no good?
Or removing bullet fragments?
This makes no sense at all, surgery I think has an immediate positive effect and then hastens healing.
Thanks,
Wayne
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Old 09-04-2017, 09:42 PM   #5
whswhs
 
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Default Re: Surgery - How does it work?

Quote:
Originally Posted by Wayne View Post
So doing surgery to repair a massive hole does no good?
How would you repair a massive hole surgically? Surgery can't create new tissue to fill the gap and replace the destroyed tissue. That takes healing, which is a physiological process, which can be aided by Physician.
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Old 09-04-2017, 09:48 PM   #6
Wayne
 
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Default Re: Surgery - How does it work?

Quote:
Originally Posted by whswhs View Post
How would you repair a massive hole surgically? Surgery can't create new tissue to fill the gap and replace the destroyed tissue. That takes healing, which is a physiological process, which can be aided by Physician.
Yes, but you can draw together muscle layers. You can then suture the subcutaneous and skin layers. Very quickly you go from an open wound to a closed wound, the person or animal can walk without fear of the intestines falling out. So an immediate benefit.
Then of course healing will be much much quicker, so yes, a physician aids there but the surgery has given an enormous head start and the healing will be more rapid.
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Old 09-04-2017, 09:59 PM   #7
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Default Re: Surgery - How does it work?

Quote:
Originally Posted by Wayne View Post
So an immediate benefit.
The immediate benefit of surgery is usually that you will stop bleeding and the continuing risk of infection decreases dramatically. The secondary benefit is that your body will be able to start healing, which it may not have been able to do with a large gaping wound or a ruptured spleen, and it can start healing in a way that is more beneficial to you - i.e. a set bone will heal in a way that will allow you to walk again instead having a permanently crippled leg.

The problem is that most of these benefits fall below the resolution of what GURPS - and most RPGs - bother to keep track of.
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Old 09-04-2017, 10:44 PM   #8
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Default Re: Surgery - How does it work?

Quote:
Originally Posted by ericbsmith View Post
The immediate benefit of surgery is usually that you will stop bleeding and the continuing risk of infection decreases dramatically. The secondary benefit is that your body will be able to start healing, which it may not have been able to do with a large gaping wound or a ruptured spleen, and it can start healing in a way that is more beneficial to you - i.e. a set bone will heal in a way that will allow you to walk again instead having a permanently crippled leg.

The problem is that most of these benefits fall below the resolution of what GURPS - and most RPGs - bother to keep track of.
That sounds right. With more detailed injury rules, many injuries would just be normal "lose HP; heal them back" basic injuries, but some would be problematic: injuries that "bleed out" internally or otherwise result in ongoing HP loss, or, going longer term, injuries that resist healing, or become infected, or heal improperly (leaving behind some sort of affliction or disadvantage, or future potential for these).

Diagnosis would be the skill to distinguish basic from problematic injuries. Physician and First Aid would be the skills to promote healing of basic injuries. Surgery would be the skill for dealing with problematic injuries. Surgery wouldn't heal HP; it'd generally cause damage (though high skill should lessen that; either way, you want a patient as healthy and stable – i.e., high HP – as possible before surgery). But it could try to stop the ongoing bleeding, or fix the internal problem (including removal of foreign bodies) that impedes healing, or help prevent lasting afflictions.

Largely beyond the scope of GURPS, though various books provide some concrete uses for Surgery. A tinkerer GM could easily come up with more.

Quick 'n' dirty example: Players rightly fear crippling as an effect of major injuries. Say there's a chance (1-2 on 1d6?) that any such injury is one that could benefit from surgery. Allow a Diagnosis roll to determine this. If diagnosed properly, allow a Surgery roll to aid the healing. This means some immediate HP loss for the surgery, plus the ever-present chance of critical failure, so it's not something to engage in lightly. But if successful, the surgery adds to the HT roll to avoid crippling – possibly a career saver for the PC.
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Old 09-04-2017, 10:49 PM   #9
Refplace
 
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Default Re: Surgery - How does it work?

Quote:
Originally Posted by Wayne View Post
Yes, but you can draw together muscle layers. You can then suture the subcutaneous and skin layers. Very quickly you go from an open wound to a closed wound, the person or animal can walk without fear of the intestines falling out. So an immediate benefit.
Then of course healing will be much much quicker, so yes, a physician aids there but the surgery has given an enormous head start and the healing will be more rapid.
I don't think you understand how surgery works.
As someone who has had a few I feel confident in saying that GURPS does ok here.
First Aid or Physician can stop the bleeding and includes stitches, so is great for saving a life and the go to skill for an emergency. If you have to undergo surgery to save your life your going to be laid up and need time to recover.
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Old 09-04-2017, 10:59 PM   #10
Varyon
 
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Default Re: Surgery - How does it work?

Let's consider what all surgery is used for in the real world, and what the closest GURPS equivalent would be.

A big one is stopping internal bleeding by patching things back together, and GURPS handles this readily - many forms of internal bleeding require Surgery (at a penalty, even) to treat, otherwise the character will simply bleed out or recover on his own. This isn't going to restore lost HP, but will prevent the character from continuing to lose it from bleeding.

Next up is repairing damaged organs. In GURPS, an organ that is sufficiently damaged enough to require Surgery is either a case of crippling (broken bone, torn muscle, etc) or is a Mortal Wound. Note this type of surgery can also serve to remove other Disadvantages, like Chronic Pain, Terminally Ill, or Wounded. Additionally, this may go beyond simple repair, with the surgeon adding some sort of implant or graft, such as a pacemaker, artificial heart, cybernetic limb, skull plate, etc. Again, no HP restored, but rather functionality is restored.

Up next, body modifications. Some of these are aesthetic in nature, such as facial surgery (reconstructive or elective), but others are more intense, such as amputations and removal of internal organs. In the former case, the character is gaining a modified appearance (changing Appearance levels, avoiding recognition, gaining Distinctive Features, etc). The latter are either done because the surgeon is (working for) a sadistic bastard or, more likely, because failure to do so would likely kill the patient (due to blood loss, infection, etc). In Ultra Tech settings, amputation could instead be a prelude to cybernetic augmentation. As you are carving away bits of the person (and possibly adding in some sort of filler material), I think it's pretty clear HP gain should not be expected here.

Finally, removal of foreign bodies. Presence of foreign bodies can outright prevent healing of an area, encourage bleeding, render the organ unusable, make the character sick (due to toxin, infection, or even just the body's response to the foreign body), result in severe pain, and/or cause further damage as the foreign body shifts (due to normal body movement, later impacts, etc). Removing these doesn't eliminate the damage that was originally caused, thus no restoration of HP, but most of the above is handled by various GURPS rules such as Lasting Wounds, crippling, etc.

Something like nanosurgery (which does repairs on the cellular level) can restore HP, but using it is completely unlike using the Surgery skill, being more akin to Physician.

...

All that said, in a cinematic setting, putting someone under the knife resulting in them recovering HP more quickly could be highly appropriate. I'm not certain what sort of mechanics would be balanced, however.
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