Watch SAW X Official Movie Trailer

In what is described in the trailer as “his most personal game,” Jigsaw comes equipped to the scene with a slew of surgery tools. “The only thing I have not provided is your anesthetic,” he hauntingly reveals. Clips of each of the doctors and nurses in chains, electric chairs and other compromising positions flash the screen, while Kramer looks on from above.

SAW X hits theaters on September 29, about a month earlier than the initially intended release date. Synnøve Macody Lund, Steven Brand, Michael Beach, and Renata Vaca also star in the film.