Mohs Surgery
What is Mohs micrographic surgery?
Mohs surgery, also known as Mohs micrographic surgery is a highly effective surgical technique for the removal of skin cancer. This specialized procedure was developed in the 1930's by Dr. Fredrick Mohs and is now well accepted by the medical community world wide. Mohs surgery differs from other skin cancer surgery in that the surgeon also serves as the pathologist allowing for immediate and, most importantly, complete microscopic evaluation of removed cancer. The method employed to examine the tissue allows for better elimination of cancer roots. Mohs surgery is currently recognized as a skin cancer treatment with the highest cure rate. Because less tissue has to be removed compared to traditional surgery Mohs may allow for better final cosmetic results.
How the Procedure is done
Our doctor will first mark the area of cancer to be treated with a sterile surgical marker. The area to be removed will be anesthetized using a combination of a short and long acting local anesthetic. You will not be put to sleep or sedated, only the area to be treated is anesthetized. Dr. Khourdaji will then remove tissue and create a map of the area treated. The tissue removed will be transferred to a histology lab in our office where the tissue will be processed and mounted on slides.
This processing takes from 30 minutes to over and hour depending on the circumstances. During this time you may read, watch TV have a friend or family member sit with you. There will be a bandage on the treatment area at this time and occasionally you may have to apply pressure to the area.
Our doctor will then read the slides to make sure all the cancer is clear from the margins. If the cancer is clear then he will discuss with you options for cosmetic repair of the defect. Most surgical defects will be repaired by Dr. Khourdaji on the same day.
If there is still remaining cancer when the slides are read, Dr Meisenheimer, will identify the location on the surgical map return and take more tissue only from the area involved. This process is repeated until the cancer has been completely cleared.
Why Mohs surgery?
Skin cancers can be deceptively small on the surface of the skin, much like an iceberg, where only the tip shows, much more can be below the surface. Cancers may have roots and just cutting off the top will not get rid of the roots. Recurrent skin cancers following previous treatments may send out roots deep under the scar. Mohs surgery is designed to treat cancers by tracking out the cancerous roots. Because of this, prior to Mohs surgery, it is impossible to predict how much skin will have to be removed. The final surgical defect may be only slightly larger than the initial skin cancer but occasionally the roots are extensive and could results in a sizable defect. Keep in mind though that Mohs surgery removes only the cancerous tissue, while normal skin is spared.
