To simplify this expression, we will start by simplifying each individual term.

1. Simplify the numerator of the first fraction:
- The numerator is (2√x / √(x+3)) + (√x / √(x-3)) - (3x+3 / x-9)
- To add or subtract fractions, we need a common denominator. In this case, the common denominator is √(x+3) * √(x-3) * (x-9).
- Multiplying the first term by (√(x-3) / √(x-3)) and the second term by (√(x+3) / √(x+3)), we get:
(2√x * √(x-3) / (√(x+3) * √(x-3))) + (√x * √(x+3) / (√(x+3) * √(x-3))) - (3x+3 * √(x+3) * √(x-3) / (√(x+3) * √(x-3) * (x-9)))
- Simplifying the numerator, we get:
(2√(x(x-3)) + √(x(x+3)) - (3x+3)√(x+3)√(x-3)) / (√(x+3) * √(x-3) * (x-9))

2. Simplify the denominator of the first fraction:
- The denominator is (2√(x-2) / √(x-3)) - 1
- To subtract fractions, we need a common denominator. In this case, the common denominator is √(x-3).
- Multiplying the second term by (√(x-3) / √(x-3)), we get:
(2√(x-2) - √(x-3)) / √(x-3)

3. Now we can simplify the entire expression by dividing the numerator by the denominator:
[(2√(x(x-3)) + √(x(x+3)) - (3x+3)√(x+3)√(x-3)) / (√(x+3) * √(x-3) * (x-9))] / [(2√(x-2) - √(x-3)) / √(x-3)]
- To divide fractions, we multiply the first fraction by the reciprocal of the second fraction:
[(2√(x(x-3)) + √(x(x+3)) - (3x+3)√(x+3)√(x-3)) / (√(x+3) * √(x-3) * (x-9))] * [√(x-3) / (2√(x-2) - √(x-3))]
- Simplifying the expression, we get:
[(2√(x(x-3)) + √(x(x+3)) - (3x+3)√(x+3)√(x-3)) * √(x-3)] / [(√(x+3) * √(x-3) * (x-9)) * (2√(x-2) - √(x-3))]

This is the simplified form of the expression.