In many MMORPG games, the term "Surgical" usually means someone is acting both cocky and n00bish, which means that the surgical person thinks they are very great, when they are a complete idiot. This originated from a player on World of Warcraft by the name of Surgical who acted this way. People often made fun of him, but Surgical would lash back in anger or mistake the insults as flattery. Insulting him soon spread to a server-wide joke, and later gained popularity elsewhere. The server this originally took place at was "Black Dragonflight"
Wow, this n00b is so surgical. Hehe, what a useless n00b.