-Tumors did not regenerate - 800
-Finished before vasoconstrictor expired - 200
-No mistakes - 700
-Completed with 230 left - 300
The thing you need to be careful with in this operation is that the time limit is very, VERY strict if you're a renegade and don't use the Healing Touch.
When the operation starts, you may raise vitals before performing the lobectomy if you want a tiny bit of help in the next part, but it's not necessary.
You'll see two tumors of the nasty variety. What we're going to do here is remove them both at once. You need to do it this way because if you treat one first and then the other, the first one will regenerate while you're working on the second. However, you will need to be very fast and very precise when working here because the patient's vitals are already dangerously low. It's highly probable that by the time you've finished removing both tumors vitals will be at single digits. In any case, remember to keep the control stick pressed towards the bottom-right, have the B button also held down, and the cursor on top of one of the tumors as the screen is transitioning. This will allow you to start draining immediately. Drain the first one completely, then immediately move over and drain the second one. When that one's drained, very quickly switch to the scalpel and start cutting off the veins of the FIRST one you drained. Remember to be very precise in where you place the cursor and to only keep the scalpel held down long enough to sever the vein. Otherwise the patient's vitals drop too much. Once you've cut off all 3 of the first tumor's veins, move on to do the same with the second one. When that one's done, very quickly switch to the forceps and remove both tumors one right after the other. There is no need to apply synthetic membranes in this one. After you've removed them, there should be a few tiny tumors left over. Take a glance at the patient's vitals. If he's about to die, inject stabilizer a little before lasering the tumors. If his vitals are around 10 or so it might not be necessary. After lasering and gelling all the tiny tumors the vitals should definitely be critical, so now start injecting stabilizer and keep doing it until vitals are maxed at 50.
Now switch to the forceps, grab the kidney and place it where the tumors used to be. After this is done, change to the syringe and fill it up with the vasoconstrictor. First we're going to inject it in the blue vein. Be careful here because you do not want to get a miss. Make sure the pointer is on the vein. It will require 2 injections before the scalpel line appears. Switch to your scalpel and make the incision, then drain the blood. We're going to perform the anastomosis by bringing that blue vein the kidney has towards the incision we just made. Use the forceps and try to move the pointer in a relatively straight line towards the incision so that you don't get a miss. Now you'll have to suture the veins together. Getting all COOLs here isn't absolutely imperative but it never hurts. I know that the place where the veins connect is very small and this might lead you to make the suture very small too, but to get the COOL, you want to make the suture much longer. Treat the vertical blue vein as a normal sized laceration and make the suture accordingly. When in doubt, make more and wider passes than you might think is necessary. Check the video to see what I mean.
Now we need to do the exact same thing but with the red vein. Just repeat the procedure. After that's done, you'll need to inject stabilizer once or twice because vitals will be dangerously low. Now switch to your scalpel and make an incision on the scalpel line that appeared at the bottom. No need to inject vasoconstrictor this time. Connect the green vein and make sure you bring the cursor over in a relatively straight line downwards. To get the COOL on this suture, do it the same as the others but this time treat it as a horizontal laceration.
After this, you'll be almost done. There'll be a very long lull where you can't do anything. Not sure why. Use it to take a look at your time. It should be at around 4 minutes. You NEED to finish the operation before it goes below 3:50 or you will not get the XS. If you are at little over 4, you have time to raise vitals to max before finishing up, but if you're not, it's better to just finish before missing the time bonus and not worry about vitals if you don't have the time.