In 1991, Tourniquet abandoned most of its 1980's metal influences and recorded a more modern sounding album titled "Psycho Surgery". On the song "Spineless", the band experimented with rap rock in the vein of Anthrax and Faith No More long before the style became popular in the late 1990s. "Psycho Surgery" showcased Kirkpatrick's classical music influences more prominently than "Stop the Bleeding", and his background in the pharmaceutical industry became apparent with many of the song's lyrics utilizing medical terminology as metaphors for social/spiritual issues. Some critics described it as if "Slayer plays Beethoven in a slightly rewritten way". On "Psycho Surgery" Tourniquet continued to work with producer Bill Metoyer, and signed a distribution agreement with Metal Blade Records. Metal Blade released "Psycho Surgery" to a wider general market audience than the band had been able to reach with "Stop the Bleeding". Intense Records released "Psycho Surgery" to Christian retail. Tourniquet released a home video (VHS) titled "Video Biopsy" the following year.