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Cleanliness of the nearby flooring, medic skill, medicine type, manipulation stat of the medic, etc..
If any of them are bad, the chance to fail will go up.
Meanwhile in a ♥♥♥♥♥♥ little prison box with animal waste, blood, dirt, no light, 3 prisoners who were bleeding out and should have died in each case, lived. They were administered to by 4 medicine pawn without medicine at all. Each lived!
Next good pawn shot apart is treated in medical ward by 8 med pawn again. Oh yeah, guess what died of infection. And the next ... and the next.
4 in a row died of infection in a sterile medical ward whilst 3 prisoners live after the operations from hell in a prison hotbox. Oh yeah, there were rotting corpses in that prison room too. This room is the definition of hell - it's used to break prisoners so we can get some target/medic practise - well, I say it is, it was - that barbarism has been outlawed under new colony management :)
So, the next op I need to do on a colonist is going to be in that ♥♥♥♥-house prison room without medicine - I'll show you Random Randy, you won't be expecting me to do that will ya'?
I'd imagine a master doctor should be able to install a prostetic leg without having his patient trembling in fear of losing his life or some organs which has nothing to do with his leg.
Failure during surgery happens way too often in my opinion.
Basically, if there's something you find annoying, fix it with the scenario editor. That's what it's there for, afterall.
First - are there was light source? It's contribute a lot.
Second - if doctors drunk up to manipulation penalty it's very bad, both sight and manipulation means a lot for operation success.
Third - for operations use at least ordinary medicine. Herbal bring penalty (60% of success chance multiplier).
Fourth - any bionic/implantation have a hardcoded minimal failure chance. So will fail even sometimes even for 20 doctor with full advanced bionic (from EPOE) in perfect hospital.
Herbal medicine is not sufficient for operations. And sometimes, it's can be not enough to cure disease in time too. This why you have more advanced medicines.
Like whoops! Sorry I sliced up your legs installing a bionic arm!