What is Mohs Micrographic Surgery?
Mohs micrographic surgery is a minor surgical procedure and very specialized way of treating skin cancers using local anesthesia (numbing). Mohs is a very precise, highly detailed technique whereby small layers of skin are removed and immediately examined under a microscope until the samples indicate that the skin cancer is completely removed. It offers the highest possible cure rates while removing as little normal skin as possible.
Click here to visit the American Society for MOHS.
The procedure begins by thoroughly numbing the area with a local anesthetic. Then all visible cancer is removed and a very thin layer of surrounding skin is taken to check for any remaining cancer cells that are otherwise invisible to the naked eye. This layer is processed using frozen sections of skin that are stained with special dyes. The dyed frozen pieces of skin are then examined under the microscope by the micrographic surgeon. The location of any remaining cancer is carefully mapped on a diagram of the surgical wound and then removed in another thin layer which will also be examined under the microscope. This process is repeated as often as necessary until all the cancer cells have been completely removed.
Mohs is special surgery because the entire edge and undersurface of each skin cancer layer is carefully examined under the microscope for the presence of very small skin cancer cells. With regular or traditional surgery, only a small amount of the tumor margins are actually examined, thereby increasing the chances that a small cell may be missed. Mohs surgery allows for examination of 100% of the tumor margins.
Mohs micrographic surgery is named in honor of Dr. Frederick Mohs, who first developed the technique in 1941.
What happens on the day of surgery?
Mohs surgery is an outpatient office procedure and you will be able to return home the same day. You will be placed on the surgical table, and the area around your skin cancer will be numbed with local anesthetic. Once it is numb, the visible cancer and a thin layer of tissue will be removed. This tissue will be carefully handled and taken to our laboratory to be processed. You will have a temporary dressing placed over the surgical wound and will be free to return to the waiting room. The surgical procedure usually takes only 10-15 minutes. However, it takes a minimum of 1-2 hours in the laboratory to process and examine the tissue. You will be asked to wait in the waiting room while the laboratory work is being done. If remaining cancer is found, you will be brought back to the surgical suite and a second thin layer will be taken from that area. This will also be processed while you wait. Although there is no way to tell before surgery how many stages will be needed, most cancers are removed in three stages or less.
We would like to make the time you spend with us as pleasant and comfortable as possible. You may wish to bring reading material with you to occupy your time. A light snack or drink is also advisable as you may be with us for several hours. Since we do not know in advance how much time will be needed to remove the cancer and repair the wound, we ask that you make no other commitments the day of your surgery.
What can I expect after Mohs Surgery?
Recovery is usually very easy and uneventful. Resting as much as possible the first few days after surgery is generally helpful. Most patients are able to return to work and normal activities shortly after having Mohs. Your physician will advise you if there are any activity precautions you take.
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