The skills involved
First aid: the most basic level of medical knowledge. Can not be used for surgery, although a failed surgery roll might mean the patient requires first aid to survive.
Medical: the skill most appropriate for surgical procedures. Used for surgery rolls, or to revive the patient if the surgery takes a turn for worse.
Beyond this point lie the following specialty skills:
Cybernetics: this skill is required to bridge the gap between the flesh and the machine. Also used for designing and troubleshooting cybernetic parts.
Biotechnology: this skill covers knowledge of the inner workings of biological systems and how to manipulate them. It is too theoretical to be useful in most medical situations. The most common application of this skill is in designing and creating biotechnical modifications and drugs.
Nanotechnology: nanotechnology is the technology for manipulating matter at atomic and molecular levels. This skill covers specifically the application of nanotechnology to the human body. Like cybernetics and biotechnology this skill is used to design and create nanotech treatments.
Any number of reasons exist why a patient might need (or want) surgery. The difficulty depends on the procedure:
Negligible: TD 10, surgical time 1h, surgical damage 1 point, surgical cost included in parts, mall clinic or other drop in bodyshop?
Minor: TD 15, surgical time 2h, surgical damage d6+1, surgical cost 500e, medical center or ripperdoc?
Major: TD 20, surgical time 4h, surgical damage 2d6+2, surgical cost 1500e, full hospital with surgery center
Critical: TD 25, surgical time 6h, surgical damage 3d6+3, surgical cost 2500e, full hospital with surgery center
Surgical times, damages and costs are mere guidelines. Some procedures do not fit neatly into these rather arbitrary categories. Adjust as needed.
When a surgical procedure is performed the patient takes the surgical damage without applying BTM (or armor, for reasons which should be obvious). If this puts the patient into a mortal state they must be stabilized or they will die on the operating table.
If the patient is already injured the GM should consider whether the surgical damage has already been done: amputating an arm is normally a Major surgery which deals 2d6+2 points of damage, but if the arm in question has already been turned into a hamburger the damage is already done. On the other hand the broken arm should do nothing to reduce the damage from amputating a leg.
Reduce surgery damage by the amount of damage judged applicable, to a minimum of one point of damage.
Most cybernetics need a surgical operation to be installed. Otherwise they would be just fancy gadgets, now wouldn’t they? If surgery is needed the correct procedure (Negligible, Minor, Major or Critical) is performed, and while the patient is open on the table the implant is installed with a TECH+Cybernetics roll. The difficulty of this roll depends on the quality and nature of the implant. Installing a high-level mind-machine interface is difficult, simply connecting the veins to an artificial liver is easy.
Simple cybernetics might be installed without a cybernetics roll (anything without a mind-machine interface) and very simple cybernetics might be implanted without the cybernetics skill at all (such as subdermal armor plating).
Obviously if the cybernetic implant can be accessed without a surgery no surgical procedures are necessary to install it. (For example adding new extras to an existing cyberarm.)
Unlike cybernetics, biotechnical implants can usually be installed with just the medical skill (since they are designed to be compatible with humans) using the correct surgical procedure. However if there is a problem the biotechnology skill might be needed to figure out what is wrong. Poor quality biotechnical implants, or heavily modified patients, might require a biotechnology roll to ease the implant’s integration into the patient’s system.
All nanotechnical modifications require no surgical operation beyond a rather serious IV drip (Negligible surgery) to install, but complications are all but certain unless the nanotechnology skill is used to tailor the treatment to the specific individual. The surgery code of a nanotech treatment represents the difficulty of tailoring the treatment to an individual and the potential for things to go wrong with it.
When nanotechnology is installed the techie tailoring the treatment rolls INT+Nanotechnology against the treatment’s task difficulty. If the roll is a success there are no complications. If the roll is a failure determine how many points the treatment failed by and consult the table below.
Roll d10 for Negligible, 2d10 for Minor, 3d10 for Major and 4d10 for Critical treatments, : Make a death save immediately at a -5 modifier. If you succeed you have one minute to write your will with your cramping hands while you cough up blood.
Most complications brought on by nanotechnology can, at least in theory, be fixed with the correct nanotechnological treatment. Such custom made treatments are even more expensive than the standard treatments.