A Scalpel is an unlockable active item in Repentance Plus, a mod for The Binding of Isaac.

-1 Red Heart container.

With each use, Isaac will fire more additional tears in random directions alongside his regular tears. These tears deal 65% damage and inherit his tear effects.

Defeat Isaac as Tainted Azazel.

A Scalpel can be found in the following item pools:

• Check out the item description on the mod's external Wiki.
• Download Repentance Plus from the Steam Workshop.