Two decades after Marathon popularized mouse controls for first-person shooters, the debate still rages over the best way to kill bad guys. Most PC players swear by the mouse and keyboard method, claiming it offers increased speed and precision for more accurate headshots. Many console owners, however, say that titles like Halo are tuned to play better on game controllers, and really who wants to use a mouse on a nice sofa in front of a big TV anyway? But this week the same argument spills from the theater of war to the theater of operation, as bloody PC hit Surgeon Simulator 2013 sees release on PlayStation 4.

On PC, Surgeon Simulator takes the precision advantage of mouse and keyboard to a ridiculous level, with deliberately fiddly controls for individual fingers as you muddle your way through complex operations; the result is often a gory disaster. This has been simplified a little for the PS4 controller — and the iPad before it — but Surgeon Simulator: Anniversary Edition is still brutally difficult. While the system is consistent enough that I can imagine someone getting good at the game, that would take a lot more effort than most people are going to put in.

You can control your virtual hand’s position in one of two ways; tilting the controller, which feels natural but often leads to inadvertent slips, or the right analog stick, which is a little more precise but less intuitive. The finger controls are streamlined to one button for the index and thumb with another for the rest of the grip, but that doesn’t make it much easier to avoid stabbing yourself with a psychedelic syringe or dropping a buzzsaw into your unfortunate patient’s ribcage. There is, for the first time, a co-op mode, which could either bring two people together to share in the joy of advanced medical care or considerably raise the risk of catastrophe.

I had one obvious question when playing Surgeon Simulator on PS4: why no support for the PlayStation Move controller? After all, if there’s one thing that Sony’s Wii remote-style stick does well, it’s tracking the position of your arm in space; it has the potential to be the easiest and most intuitive control scheme yet. But maybe that’s the point — Surgeon Simulator is less game than chaotic party trick, where failing is half the fun whether you’re playing or watching. Giving it better controls would be like adding joystick support to QWOP.

The field of remote surgery is accelerating all the time, but I really hope the surgeons involved have better tools than a mouse or PS4 controller. On that level, at least, Surgeon Simulator: Anniversary Edition is a successful port of the PC game.

Surgeon Simulator: Anniversary Edition is out now on PlayStation 4 for $12.99.