This doesn't prevent it from being permanently banished by other methods of removal, but, considering the other starter deck in this set only cares about challenging, there's a good chance this will be a persistent problem for your opponent
So if you Extort a spell and have 3 opponents, each one of them loses 1 life and you gain 3
That otter just wants to play fetch, and he got that ball because he's a good boy (yes he is!)
The rarest neon red version of the card is worth over $1,000
draw unlimited cards, and then box the other players out of the game
Those cards supplanting Surgical Extraction has a bunch of other impacts on the rest of the format, allowing decks like Esper Reanimator to exist