This item can only be worn around Halloween or during a Full Moon; at other times of the year, it does not appear in gameplay, unless the server has Halloween mode enabled. However, it can be equipped at any time and can still be viewed on the loadout screen even when it is not visible during games.
The Trepanabotomizer was contributed to the Steam Workshop under the name "Quack's Cure-all".
- The Trepanabotomizer was added to the game.
- The name of the item is a mix of words "trepanation" (a surgical intervention in which a hole is drilled or scraped into the human skull) and "lobotomy" (a procedure which consists of cutting or scraping away most of the connections to and from the prefrontal cortex, the anterior part of the frontal lobes of the brain)