Approach - GETT is listed as the primary approach. If the bladder tumor is on the LATERAL sides of the bladder, there's a chance that the cautery could stimulate the obturator nerve and cause the patient to abruptly move. This can cause perforation of the bladder. Therefore, if you don't readily know the location of the tumor and/or the surgeon said whether or not to use paralytics, a GETT approach with paralytics is the safe approach.