Surgical Extraction has a kind of strange history. For the longest time it was a card often ignored by casuals, loved by brewers and players that where building their first competitive decks, shrugged off as crap by experienced players and pros.
When i first got into Modern a few years ago, i cramped the card into sideboards every time i could defend it in deck and the current local meta. Over time i played it less and less, and then even traded my play set away.

Now apparently the card suddenly sees play absolutely everywhere in modern and legacy and the price has gone through the roof as a result. I don't follow those two formats so i have no idea at all why this is the case now. Was something else printed that makes the card good now? Where all the pros speaking out against the card for years just wrong, or is the card just over hyped at the moment? It could be the same case as it was with deaths shadow in modern, where all the cards used in death shadow decks where legal for years, but it just catched on a while ago.

Most importantly: How playable is this card in Vintage, did we overlook it as much as the legacy and modern players did?

@Aelien

It's played in modern because modern has linear graveyard strategies. 4 of griselbrand is a real thing in that format. Catching you at that all in moment in your combo in modern you lose.

Modern is also a more pure card advantage format. So the chance of getting another card out of your opponent's hand is a good line.

Other graveyard hate in the format doesn't really help battle many of the decks. Tormod's crypt isn't as good because decks will just start over. Enter Surgical extraction. Take your wincon and you lose.

That's not the case in legacy or vintage. This card sees less play in legacy than faerie macabre sees. The reason for that is counter magic, and the only cards you want to get with Surgical extraction are in Lands. And even then they can still easily win through a Surgical extraction.

In vintage, its effect is even worse. Dredge doesn't need any single card to win. Vintage is also less of a card advantage format and more of a power format. Which player is doing the more broken things wins, not which player got +2 in the card advantage area like Modern.

In short, the card simply isn't great in Vintage. It's still playable. It's just not outstanding like it is in Modern.

Another factor is that Mental Misstep is rampant in Vintage and banned in other formats.

I don't think anyone ever shrugged Surgical Extraction off as crap. None of the phyrexian mana spells are crap, and vintage has seen a lot more of these cards played than any other format. Slash Panther, Porcelain Legionnaire, Noxious Revival, Mental Misstep, and Dismember have all been in high profile decks. (I'm sure I'm forgetting one too).

Extirpate has seen play in the past, and is arguably the better card for Vintage.

Surgical Extraction is in about 90% of Eldrazi Tron sideboards because of the Ghost Quarter into Surgical Extraction line. It gives you an edge against the mirror match, Valakut decks, and anything else that relies on unique lands to fuel its tempo or win condition. It also provides splash damage against Living End and Dredge, but plays backup to Chalice of the Void and Grafdigger's Cage in those situations since those decks can't be hosed by a single Surgical Extraction. Grixis Death's Shadow plays too many unique threats and Goryo's Breach doesn't exist in the current high-level metagame to take those decks into consideration.

I've seen posts from @Stormanimagus doing the same thing Eldrazi Tron does in Vintage Humans decks, but with Wasteland and Strip Mine. Humans is a deck that punishes people for including Mental Misstep and attempts to capitalize on that after sideboard.

Sorry but I think you guys are tripping. Modern is the format where CA is the least important, since it's a tempo-based format.
Also, Surgical Extraction is popular in both formats for several reasons. Reanimator, Snapcaster, Storm, Kolaghan's Command, the occasional dredge and several other interactions I won't care to mention.
It's less used in Vintage because of the 1-of nature of the format, because reanimator is shitty in the format and because it sucks against dredge.

EDIT: Surgical does fight for slots with Faerie Macabre and Leyline of the Void in Legacy, but every Snapcaster deck will opt for Surgical.

So with the rise of Survival, do you think we could give this card another look, as a card that isnt hardcore GY hate, but rather flexible against alot of strategies and is obviesly very easy to cast. This is a card that could be brought in to fight Snapcaster and JVP Decks without having to bring in clunky hard GY hate. Maybe this could be considered as GY hate 5-6.

@aelien It's not as good against Survival as you want it to be. With open mana and or an untapped Bazaar, you can drop a double Basking Rootwalla and cast at instant speed to trigger any Vengevines in the yard to return to play and effectively countering your Surgical. Even without being able to get VV out of the yard, most lists run a Spell Queller to alleviate problems like Surgical. It's not that it's bad, it's just not as good as you want it to be. Hell, I normally board in Grafdigger's Cage and Containment Priest and just play around them.

@yayjinaz Aaactually it's pretty good. You should use always when the VV is triggered, because it won't be able to be triggered in response (others also won't). And Spell Queller, even if it was run in most lists (which it's not, only in the old bant list), won't be able to be cast if you play it in response to the VV trigger. You'd have to have tons of mana and it already in hand or even other creature to pitch it to fetch queller.

BTW: the newer lists are running 3-4 mental missteps. If you run surgical, that's what you should have in mind. I've had several VV extracted, even running misstep, it's just rare to have missteps when you start triggering them all. You usually use them before.

But still, I'm not sure if that's the best card to play as graveyard hate. You get VV from survival, but I don't think it's really good to play against snapcaster decks, as that's probably the only relevant think you'll do (delve cards delve as cost, so you can't respond, actually they can even remove the surgical target - not that it matters, since what you really want is just to remove it)

@GutoCmtt I would imagine it could be decent against PO, but I have no idea.

Surgical is pretty good if you run a lot of them. When I was trying it out in my sideboard, I felt that I needed to draw it early on in the game, and consistently throughout the game in order to really control the game. It sucks when you draw Surgical after all of their Vengevines, Narcomoebas (if against Dredge), etc. are already in play. But you effectively take away one of their game plans (the one you dislike the most) if you have it in your opening hand or draw it turn 1 or 2.

The decks you're going to use Surgical against usually don't have as many Mental Missteps in hand as a blue deck would, even if they run 4. I tried including 4 Surgicals + 2 Extirpates in my sideboard (taking all other graveyard hate out) one day for shits and giggles, but they could completely destroy their graveyard, library and hand. Also, Surgicals aren't that bad against topdeck aggro decks like WEldrazi, as long as you have some removal.