-Max chain over 150 - 500
-No mistakes - 500
-Completed with 200 left - 300
-Less than 5 membranes multiplied - 700
This is a fun operation. You'll be fighting Triti, Kyriaki, Deftera and Paraskevi in that order. One right after the other. Your priorities in this operations are firstly to get no misses, and secondly to not break your chain. Thirdly, even if you do the operation perfectly you might still not get enough points for the XS. So we'll have to do something about that. Read on.
Alright, the first patient has Triti. It works the same way as it always has:
Triti is made up of two parts: membranes and thorns. What you want to do is remove all of the membranes from the pancreas. However, each membrane is embedded into the organ by three thorns in each corner. To remove a membrane, first you must remove all of the thorns surrounding it. The thorns also regenerate after a few seconds.
The big problem, of course, is the way the membranes multiply. First of all, notice that membranes only multiply based on what you do. Notice that if you don't do anything, they will never multiply. This means that, while speed is still important, it's also important to know what you are doing.
Notice that membranes can only multiply when you remove one with the forceps. Simply removing thorns does not allow them to. Now, the trick to Triti's nightmarish multiplication is simply this: if there are two thorns adjacent to each other, and there is a free space next to them, a new membrane will appear there when you remove a membrane on any part of the organ. Therefore, the trick lies in looking at the thorns. What you want to do is only remove membranes when there are no adjacent thorns currently present. The exception is when there is no free space where two adjacent thorns can create a new membrane. This is either because there is already a membrane there, or because it's the edge of the organ and there is no actual room for a membrane to appear.
You're going to be using your forceps almost exclusively here. I recommend that you grab the wiimote in a specific way here: place your thumb over the A button and grip the remote firmly with it. That's right, you're going to have the A button constantly pressed throughout this operation. Never let go of it until you're done. If you have the A button pressed, then you can simply use the B button to grab and let go of things with the forceps. There is no need to press and let go of both buttons. Using a single button affords much greater control over the remote. When pulling thorns in general, remember that they are embedded in the organ. You want to pull UPWARDS when grabbing them before placing them on the tray. If you simply pull to the right, you will get a miss and forfeit the entire operation. This is important, so always remember to pull in an upward motion.
Now what follows is the way to XS this specific operation. Understanding Triti and the meaning behind what you're going to do is good, but if you follow these directions you can XS the operation without having to understand it:
When you get inside there will be 10 membranes in a really funky pattern. Look at the thorns. What we're going to use as a point of reference in these directions is the rows of thorns. When you start there will be 4 rows. From top to bottom the first row will have 2, the second will have 4, the third will have 5, and the last will have 4.
From top to bottom we'll call these row 1, row 2, row 3 and row 4. Now, as soon as you can, I want you to remove the 3 middle thorns from row 3. Then quickly remove all of the thorns from row 1, and both middle thorns from row 2. Then remove the two membranes at the very top. Now you only have 8 membranes, and row 1 will be gone. No new membranes should have been created. Wait for all the thorns to regenerate while you inject some stabilizer.
Next, remove the left thorn from the top row, both left thorns from the middle row, and both left thorns from the bottom row. If a thorn turns into gas ignore it for now. Then remove the rightmost thorn from the top row, and the second thorn starting from the right on the middle row. Now very quickly remove the three leftmost membranes. Drain any gas. Now you're down to 5 membranes and no new ones should have been created. Wait for the thorns to regenerate while you raise vitals.
Remove either of the thorns on the top row, then the two leftmost ones on the middle row, and the two leftmost ones on the bottom row. Remove both membranes on the bottom left. We're down to 3 membranes. Again, wait for the thorns to regenerate.
Remove the three thorns holding down the left membrane and remove it. Only two membranes left. Wait for the thorns to renegerate, then quickly remove all 4 thorns holding them together and both membranes. Drain any gas after all membranes are gone. That'll be it for this patient. Watch my video for the demonstration of these instructions. Make the final suture and apply the bandage, make sure not to get a miss. You should have finished this part in less than a minute.
Now we move on to the next one. Get inside. It's Kyriaki. This one works exactly the same way as all the other Kyriakis so you should have no problems when dealing with it. However, remember that if you work too well and too quickly, Kyriaki won't have a chance to cause many lacerations. It's very easy to miss the mark on the score needed for the XS in this operation, and to avoid this we will approach this part in such a way that we will let Kyriaki cause more damage than we normally would.
When you get inside you'll see a bunch of normal lacerations and a huge one. Take care of them all. Remember to get COOLs in as many as possible. Don't raise vitals yet. I did raise them in the video because I suck and forgot, but just because I suck doesn't mean you have to! After suturing them, two Kyriaki will appear. Suture the two lacerations, then find them with the ultrasound like always, and bring them up to the surface with the scalpel. Now wait a second. Don't kill them immediately. Remember what we said. Suture all of the lacerations. What we're going to do at this point is raise vitals to max while they're running around, and hopefully they will create a few more lacerations that we can suture while we do that. Once vitals are maxed out, you can wait a few seconds and see if they want to make some more lacerations, but if you see that they stay passive for more than 5 seconds just kill them.
Now two more Kyriaki will spawn. Treat them exactly the same way as you did the last two. Remember to raise vitals when they're running around so they can make a few more lacerations than normal.
Now the boss Kyriaki will spawn, escorted by a single small one. He will create his trademark triple slash. Treat the 3 lacerations as you always have. Now, normally you'd take care of the small Kyriaki first since it dies in one shot, but here you're going to kill the boss first so that the little one can run around for a while making lacerations as you're doing this. Once the boss is dead go ahead and kill the little guy. That'll be it for this patient. By the time you're done with this one I'd recommend your chain being above 100.
Next up we've got Deftera. This one's going to work the same way as the last Deftera you treated, the only difference is this time random pools of blood will form that may obstruct you. You'll have to drain them periodically. Along with Kyriaki, this is the other part where stall tactics could work to your benefit. Be careful when stalling with Deftera though, because it's much more dangerous. Having too many tumors sitting at once can potentially destroy vitals before you even know what happened. If you're lucky, Deftera will act so aggressively that you won't have to stall too much on purpose. If you're unlucky, both will be suicidal and hardly do anything.
Therefore, if you see that they're acting aggressively, just laser off every tumor that appears as quickly as possible. If you see that they're being too passive, it might be a good idea to let some tumors fester for a while and create additional tiny ones.
Go ahead and drain both pairs twice as fast as you can. Before the final drainage, however, use your judgement. If you feel that they've caused a good amount of trouble up till now, go for the kill. If you feel that they haven't done much, stall for a bit and let them create some more tumors until you feel relatively satisfied. If you want some kind of meterstick to go by, I'd say you can start killing them once your chain is above 150.
Remember, don't bother draining the Deftera if there are still tumors around. This will cause the drainage to fail and it will just be wasted time.
When you're excising the Deftera, you know how it works already: It gives you a little bit of time to get ready before the lines appear, so what I'd recommend is to start moving the scalpel where you THINK the lines will appear before they do so that you waste no time, and also so you're already comfortably making the right motion. Don't cut too fast because you want to get every dot on the first pass. If you do this fast enough the Deftera will only get a chance to create a single tumor. Burn this tumor off before you grab the Deftera with the forceps and place it on the tray. Then simply apply the synthetic membrane and gel over it. If vitals are really high, you can let it create some more tumors during this part to get some more points. But if vitals are, say, below 50, it's not really all that advisable.
Now it's time to move on to the final patient. You should have finished Deftera before the clock goes below 6. But if it has gone a bit below that, don't worry too much. You still have plenty of time. You have to finish before 3:20. This last part will be Paraskevi. It works exactly the same as the first Paraskevi you treated, except it's already in the patient's heart, so you have to be extra careful and not let it burrow even once. Stall tactics are useless here, so just finish it off as quickly as you can. Major dangers are 1) picking up the wrong body and getting a miss 2) picking up a body when it's not paralyzed and obviously 3) letting a body burrow. So it's important to be careful in this operation.
Other than that, it's the same as the last time:
Pay attention to the tail. When it starts vibrating, it means it's about to burrow, so quickly paralyze it before it gets the chance. Once it's paralyzed, you'll have to switch to the scalpel and slash it's midsection to start killing it. Remember to slash along the MIDDLE. Any other part won't work. Once you do, it will turn into two bodies and create two lacerations. Before dealing with the lacerations, it's a good idea to paralyze the two bodies first so they don't burrow while you're busy suturing. Now, we're going to repeat the procedure and slash one of the two bodies. This will have the same effect as the last time. It will divide in two and cause two lacerations. Now you have 3 bodies to worry about.
What you're going to do from here on out is concentrate on slashing ONLY the smallest body currently present. You will do this so you can reduce the number of Paraskevi while keeping the number you have to worry about at one time down to the most manageable level. Therefore, other than periodically paralyzing them with the laser, you will ignore the larger bodies and only slash the smallest ones. You should keep working the same way as you go on, paralyze, slash, paralyze all, suture, paralyze again, slash etc. However, once you slash a body down to the smallest size, that is, to only a tail and head, what you'll want to do is, instead of suturing the lacerations after paralzing everything, ignore them for a bit, and instead, pick up the two smallest bodies comprised of only the head and tail as soon as you paralyze them. Only after these two are gone should you suture the lacerations. The reason is that the smallest ones move too fast, plus by that point there will be a very large number of them, and if you can get rid of two that fast and easily, it's better to get them out of the way first.
After that, move on to the smallest body currently present and start working that one down. Do everything exactly the same way until there are no more Paraskevi. Raise vitals whenever you want, but make sure that all the bodies are paralyzed when you do.
Sometimes there may be too many Paraskevis moving around to paralyze all of them. This is when their signals come in handy. You can actually choose to let a body roam around as long as its tail isn't vibrating. However, the ones whose tails ARE vibrating should be lasered as soon as possible. As a matter of fact, if you're good at watching for those signals, it could be in your best interest to only paralyze bodies when absolutely necessary. This can certainly help to make things go faster for you.Finally, be careful when picking up the smallest bodies. Firstly, make sure they're paralyzed, and secondly, make sure that they aren't near another body, because then you could accidentally pick up the wrong one and get a miss. If you paralyze a tiny Paraskevi and a larger one near each other, it might be best to let the paralysis wear off so they can get some distance from each other.
Remember to get COOLs in as many sutures as possible. Score is very, very important for the XS. If you get below 24000 points when it's all over, you will only get an S. Lastly don't forget to raise vitals to 99 on the last patient before you apply the bandage.