I had an open RPLND. It was a real bitch but I’m glad I did it over chemo. I had an initially “clear” ct scan when it was read locally by the people that did my orchiectomy. I got a second opinion at a major teaching hospital and the radiologists there noticed that the initial ct scan was, in fact, not clear at all. I had lymph nodes that were enlarged but not technically “bulky”. I had an RPLND and histology reported those lymph nodes were, indeed, positive for cancer.

In my opinion the RPLND is so much better than 1x chemo...and if there are suspicions (from ct scans) that there are cancer-positive lymph nodes...then open over laparoscopic is the only way to go. Getting the O-RPLND before the lymph nodes get bulky is so much safer than chemo.