It's not a great analogy, because surgery is not a inherently creative process the way game development is. Plenty of games are created by jumping right in and

It's not a great analogy, because surgery is not a inherently creative process the way game development is. Plenty of games are created by jumping right in and starting to code, and then seeing where that takes you. For example, the throwaway game that inspired Portal. Of course, eventually you do have to take periodic breaks to review things and plan the next phase.