Is it typical to have lymph nodes removal during RALP? How many?

Could be other factors influencing factors from biopsy, high PSA. My understanding is risk. Although my PET was negative for the lymph nodes, he still removed my left side obturator nodes to be double checked. I believe it may have been 10. I turned out to be a Gleason 7 4+3. I asked him about the removal prior to surgery and my concern with lymphedema in the legs. He said it was not a concern as the obturator nodes are specifically tied to the prostate.

@wheel1 Ah thank you. These details are what I am interested. I didn't want to talk the Center of Excellence surgeon with a little more understanding.

They removed an "Unknown Number" of lymph nodes during my RARP. My path report, surgery notes etc never gave an exact number it just says "Unknown Number".

I would definitely want to know if they are going to remove more than three or four lymph nodes. It actually is not beneficial for people to have a lot of lymph nodes removed. In some cases, people have had to have shunts to remove liquid created from them removal of lymph nodes that weren’t properly cauterized.

If you had a PSMA pet scan, they would know if any of the lymph nodes lit up and needed to be removed. Somebody with a 3+4 that is isolated to the prostate and caught early really wouldn’t need to have many lymph nodes removed. I was a 3+4 going into surgery and they did not remove any lymph nodes. I’ve never had a problem with them in the 16 years since.

Here is some more information about this

Lymph nodes aren't just passive waiting rooms for immune cells, they actively train and educate T cells, and send them off to do their job," said Professor Axel Kallies, PhD, Laboratory Head at the Doherty Institute and the corresponding author on both studies. "Our research suggests that removing lymph nodes during cancer surgery, a common practice to prevent tumor spread, may inadvertently reduce the effectiveness of treatments, such as checkpoint blockade and CAR T cell therapies. Preserving lymph nodes could strengthen immune responses and increase the effectiveness of immunotherapy."

But what are lymph nodes, and what do they do?
Lymph nodes are small, bean-shaped organs scattered throughout the body that act as checkpoints of the immune system. They filter lymph fluid, which drains from tissues, trapping and destroying germs, cancer cells, and other harmful material. Inside, lymph nodes are packed with immune cells like T cells, B cells, and dendritic cells that communicate, train, and multiply in response to threats.

In Europe nodes are "sampled" during PC surgery in about 90% of surgeries, in the USA in about 65% of PC surgeries.

I certainly wish that nodes were examined in my husband's case.

Here is one good article :
https://www.renalandurologynews.com/news/higher-number-of-lymph-nodes-removed-lower-death-risk-in-intermediate-and-high-risk-prostate-cancer/
However, you seem to have very low grade cancer and perhaps it is not absolutely necessary. Maybe only few can be examined ?

I had two sampled. They told me that they cut out a determined area and analyze the nodes therein. So, the final number is somewhat random.

@jeffmarc There’s probably a lot to that idea that lymph nodes might me way more important than we think.
In 2019, my surgeon only removed one lymph gland on each side - the surgical notes called it the ‘bullseye node’ - and that was it.
Initially I was very angry because I felt that my high volume G4+3 deserved further dissection; even Sloan told me they remove at least 6 per side routinely.
But since then I’ve come to feel that the surgeon was correct in his actions. My 2 nodes were clear; and if they were not he probably would have told me to go straight to radiation. I mean, if it’s in the very first node there’s a distinct possibility that it made its way down the chain and even the ‘all clear’ signal from the pathologist on the 6th node wouldn’t guarantee zero spread.
All it takes is one atypical PCa cell which doesn’t stain like the others or even look like the others, and even the best pathologist can be fooled.
Phil