I loved playing the original Trauma Center: Under the Knife. Although it hinged on a zany story and dialogue that went on for far too long - the essential elements of a great game were all there. The gameplay was very fresh and exciting, mastering the game required equal parts dexterity and ingenuity, and the learning curve was very fair. You improved a great deal over the course of the game.
At a very core level, this surgery simulator required you to select the proper tool from the sidebars, then apply it properly on your patient. You switched tools a great deal, so mastering the various operations hinged largely on your ability to "learn" the locations of the tools, such that you could select them without moving your eyes (and attention) from the screen.
Unfortunately, the Wii revision of this excellent game stumbles a bit more than it innovates. The controls have been very adequately mapped to the Wii remote and nunchuk, but this remapping changes the difficulty of swapping tools - you can now swap without actually moving your pointer at all. This makes some of the formerly challenging actions a snap - which is a double-edged sword.
Because the developers still wanted to make the challenge level of the game relatively high - they were forced to adjust the missions in light of the fact that tools could now be swapped at lightning speed. Unfortunately, they largely accomplished this by requiring fewer tools for each job - and by tightening the requirements for completion. This means that you pass some missions easily, and can be totally stymied by those missions that surprise you. Passing these more difficult missions is largely a matter of trial and error - not a matter of honing your skills.
Many of the visuals in the game have also undergone a revision - mostly for the better. The sounds and effects are cleaner and crisper. I didn't agree with their decision to change the look of the parasites however - on the small DS screen they were all presented in an ultra-clean art style which made them really pop out from the surrounding area. On the Wii, for whatever reason, they are a pale translucent blue. This makes the game subtly harder - but not in a way that I appreciate.
So far as Wii controls, this game is 100% pointer, which is an excellent application of the technology. Accelerometers might be checked during one "turn the screw" element - but I suspect they aren't even strictly necessary even then.
Because this game is so different from other games, it will be a critical favorite. But I believe that translating a DS game to the Wii requires a bit more re-design than was applied in this case. It is very possible that a sequel might iron out the bugs - provided it isn't cross-platform. If it is, I'm certainly buying the DS version.