Inochi no Tenbin (Balance of Life) is the sequel to the first Dokuta game that was released in 2004 as the first of a brand-new genre of surgery simulation games for the DS. The game is set after the first game, about a year afterwards. You are a doctor in a very big hospital full of people waiting to be examined, so get those gloves on and get ready for diagnosing and performing surgery on a wide variety of ailments!

The game, while played out as if you're participating in a Japanese General Hospital episode, has all of the aspects of a real hospital, even though the game does take it much less seriously than its later counterpart, Trauma Center. You have missions that are split into individual patients with issues ranging from minor to life-threatening. You go through the process of meeting, examining, diagnosing, and healing their ailments and illnesses: the first patient you meet is an adult woman who's been having stomach pains and fatigue problems. When you first meet her, you talk with her about her symptoms and use your hands to check pain levels and whether the area feels as it should. Take a rub at her stomach and watch her face for reactions. When you hit the right spot, she'll give a pained reaction and tell you exactly how much it hurts.

Progression from here depends on speaking with numerous characters that work around the hospital your practice is in, gathering information on blood work and specialist's opinions on the situation, and then moving ahead with medication and/or operation as is seen fit by you and your peers. The game, while realistic in its take on the entire process of hospital work, gets comedic in its relationships between characters. They like yelling at each other, getting disgruntled, and walking away from conversations. There isn't one set way you can go about gathering information about each patient, but there are quite a few conventional methods that you have to go through in order to unlock the next stage of your work with each patient.

You get an assistant to work with as well, and she's a huge help when it comes to the operations you have to go through. Every surgery begins with disinfectant. You move onto the scalpel instrument for making the incisions, clamps and forceps for keeping the surgery area clean, and other tools like scissors and ultrasound. While performer the operation, you have a miss meter that calculates how well you're performing each aspect of the surgery. If your hands shake, or you hit the wrong spot with an instrument, your miss meter goes down and you risk killing the patient you're operating on with your mistakes. The patient has a heart monitor that shows how well they're holding up during the entire ordeal. When the surgery is complete and you've succeeded, you sew the wounds up starting from the innermost incisions and work your way outward. Once you've completed every step, your score overall is shown and your work is graded.