Trepanation is an unlockable passive item in Furtherance, a mod for The Binding of Isaac.

After every 15 tears fired, Isaac will fire a large arcing tear that bursts into smaller tears upon hitting something or falling to the ground.

Defeat The Beast as Tainted Peter.

Trepanation can be found in the following item pools:

The following tags are applied to this item:

• Download Furtherance from the Steam Workshop.