The existence of top surgery and bottom surgery implies the existence of up surgery, down surgery, strange surgery and charm surgery
"Mr. ...um?"
"Doctor."
"All right, Mr. Doctor--"
"It's Strange."
"Maybe. Who am I to judge? "
By extension this implies that if you combined up surgery, another up surgery, down surgery, down surgery, then did b surgery, a surgery, b, surgery, a surgery, and start surgery, that you unlock Konami surgery.,