Warning: This is an affront to your eyes and your graphic card

Reverse Knockback Torchoak Totems has been my pet build for the last like ten leagues and while its damage and survivability has always been decent enough for endgame content, it never really felt comfortable to play because of the lack of leech or consistent regen. The reworked Master Surgeon on Pathfinder solves this problem, making the build a lot more satisfying to play.

For people who are unfamiliar with the build, RAT Nuke was a Build of the Week (by Russelhentz) six years ago that utilized ranged attack totems (now Ballista) to suck up monsters using Empire's Grasp, igniting them in the process to proc Eye of Innocence and then reflect damage from a Chieftain ascendancy (now the Torchoak Step boots.) Jousis also has a video of his own version using Blast Rain. The main changes since the Build of the Week and Jousis' version is that Galvanic Arrow + Barrage support is way more damage and using a permaflask setup with max roll ignite chance allows any build to get to 100% ignite chance pretty easily.

Basic mapping

Uber Maven

The coolest thing about the build is how cheap it is to start up. All you really need is a level 21 ballista totem gem, torchoak step, a 5L quill rain, empire's grasp, the siege, and eye of innocence for enough damage to clear T16s easily. This all costs like under 40c total after the first weekend. It is also comparatively cheap to get to "pinnacle viable", having personally spent no more than 5 divines* for the gear I used to kill Uber Maven, Uber Eater, and UU Elder. The humongous asterisk here is that nearly all the BiS gear for this build is random double corruptions and a Forbidden Shako, which are incredibly limited and will have highly variable prices throughout the league.

(looked up totem life, max life jewels recently and I guess the other explodey totem build really skyrocketed their costs; those'll be cheap again next league I think!)

Defenses take advantage of the fact that this build derives most of its damage from only like three stats. I use Replica Shroud of the Lightless, Avatar of the Veil, and some ele avoid nodes to get 100% ignite/shock/chill/freeze avoid, 100% stun avoid, 100% bleed avoid, and 100% curse reduction from a flask. Determination and seven "increased armour if you haven't killed" abyssal jewels to pump up my armor and cap out my molten shell. Ruby/Sapphire/Topaz permaflask which has become standard on Pathfinder. A life flask on top of all of this to give us regen and we're cruising through maps pretty smoothly (or as smoothly as this build can go)

One thing that hypercharges the build is Sniper's Mark. The five extra projectiles I don't believe actually hit single targets (this goes crazy in groups of mobs though) but they do proc Galvanic Arrow's cones, which gives us 5 extra hits per projectile anyway. Since reducing resistances is one of the only ways we can scale damage, we stack a bunch of curses: ele weak, flammability, and sniper's mark. I use Divergent Purifying Flame, Enhance, and the helm enchant give me an extra 19% increased damage taken on the consecrated ground it makes. Crucible also gives us 30% increased attack speed on Quill Rain for free since we don't care about damage reduction and stuff like cull on marked and a bunch of intelligence to hit requirements. We don't use Vaal Breach even though it is a huge damage boost just because it is unfeasible to use on pinnacle bosses and unnecessary in maps. Maybe usable on Exarch who just stands there menacingly.

I think I end up with 8M (totem life * totems * projectiles(2) * attack speed) base damage prior to curses, increased damage taken effects, and Sniper's Mark which in theory is something like 400% more damage.

My forum guide which has better formatting

Generic endgame POB