You gonna get down, or you gonna lay down?

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Special Bonus

-No Healing Touch - 100
-Completed with 60 left - 900
-Max chain over 20 - 1000

This had the potential to be the hardest operation in the game, but they decided to pussify it and let you get misses and still get the XS. So as it is, it's really easy and the only obstacle you have is reaching the max chain needed before you can start missing to your heart's content.

When you get inside the patient, you'll see three diverticula. Normally I'd tell you to inject them all one right after the other, but these ain't yo momma's diverticula. These are extreme diverticula. The effect of the serum wears off frighteningly fast. If you're very fast you can inject and excise two of them at the same time like I did in the video, but if you want to be safe just take care of them one at a time. That is to say, inject the serum, cut it with the scalpel, move on to the second one, inject and cut, move to the third, inject and cut. Then remove all of them one right after the other like you'd normally do, apply the synthetic membranes and gel. Before the Tetarti appear you'll get a chance to raise vitals to max, so do it.

By the time you're done with all the tumors your chain should be at 17. That means that you only need to make sure you get past the first wave without missing, and then you can go crazy.

Most of the waves are the faster Tetarti that constantly spew gas. This means that you don't need to worry about color, because it's always there. All you need to worry about is hitting them with the injection. Since they're much faster, their tendency for sharp turns becomes even more of a problem. The general rules from the normal Tetarti still pretty much apply to this one as well:

Generally speaking Tetarti will make sharp turns when it hits the edges of the organ or one of the other bodies. Usually when it makes a sharp turn it will not make another one immediately unless it hits something. Use this to your advantage. If you notice that it has just made a turn, you can be pretty confident that it will keep moving forward, which makes it easier to inject safely. If you see that it's about to hit an edge or another one of the bodies, it's probably a good idea to wait a little until after he's made the turn just to be safe. The "trick" here is to only inject a body immediately after it has made a turn (and it's not about to hit anything). These Tetarti will also not burrow after a while. They will only keep running around.

So if you don't want to get misses here's the deal: 1) keep a steady hand 2) don't rush if you're on a fast wave, because they never burrow and the effect of the serum lasts for much longer than you might realize 3)only inject immediately AFTER they have made a turn.

For the slow Tetarti, you have to watch for their color at the start. Injecting them is a bit easier since they're slower, but you have to be quicker because they burrow after only a short while.

The longer Tetarti run around, the lower vitals go. But don't worry too much. You get a chance to raise vitals a lot in between waves, and so you should. You can get as many as 3 full injections in between waves.

Alternatively, if you don't want to avoid misses on even the first wave, you can get your chain all the way up to 20 on the diverticula alone. To do this, first inject all 3 of them with the right serum one right after the other. I recommend starting with the green one. Let the serum on each one wear off, then inject them a second time. This time cutting each one with the scalpel. Then proceed as normal. The thing is that by injecting them twice, instead of greeting the first wave with a chain of 17, you do it with a chain of 20. Thus you can start missing immediately without fear.

I've done the Derek video with no misses, and the Naomi video with many misses using the diverticula strategy in the above paragraph to show you how it can be done both ways.

The final suture in this operation is very weird. To get the COOL on it, you shouldn't make the suture lines throughout the entire opening like you normally do, but instead, only make them in the very center. Check the video to see what I mean.