Amateur Surgeon from Adult Swim is the first rated M game to make it to the App Store, and it’s cartoony blood and violence is an interesting evolution for the platform, and a sign that Apple is adapting to the limits of the iPhone and its content in fascinating ways.

The game itself: You play an incompetent surgeon who uses all manner of ghoulish household devices to perform surgery on patients. There’s 27 different levels plus 3 hidden levels, you can save your progress, and each “puzzle” has a different multi-step solution. You can touch and glide your finger on the screen to do various things; cauterize wounds, apply gel, etc.

The app is only downloadable by those 17 or over, and is $4.99 at the App Store. It will be curious to see if more M rated games follow, or if there’s a wait and see thing to observe how this one does in the marketplace.