Grotesque (グロテスク, Gurotesuku) is a 2009 Japanese exploitation horror film written and directed by Kōji Shiraishi.

Sometimes, he stops the torture to provide medical assistance and treat the couple's wounds, so they can continue to live for a longer period of time.

It gradually becomes apparent that the man has professional medical training, refined manners, and fine taste, preferring classical music, good wine, and expensive clothes.

He mentions he is wealthy, suggesting he may be a reputable surgeon, not merely a violent sadist, looking for an extreme way to obtain satisfaction in his lonely life.

If Kazuo can cross the room to the other side (pulling his entire intestine out of his body in the process) and cut Aki's ropes with scissors to release her, both will be freed.

However, Kazuo fails due to blood loss, and it is revealed that the ropes restraining Aki have a metal wire running through them; the task was therefore impossible regardless.

[1] BBFC director David Cook explained "Unlike other recent 'torture' themed horror works, such as the Saw and Hostel series, Grotesque features minimal narrative or character development and presents the audience with little more than an unrelenting and escalating scenario of humiliation, brutality and sadism.

[citation needed] Derek Elley of Variety had a lukewarm response to Grotesque, offering kudos to aspects such as the acting and the production values, while criticizing others such as the inconsistent special effects, and opining that the "ridiculous" finale "blows any built-up tension and generates chuckles more than anything else".

Brilliant, disgusting, well written, sadistic and painful to your senses beyond belief" and concluding that it was "a solid effort" that deserves "an A for a great and outrageous ending".