Mohs Surgery
Mohs Micrographic Surgery is an advanced technique for skin cancer removal. In this
state-of-the-art-treatment, the physician serves as surgeon, pathologist and
reconstructive surgeon. Removal of the skin cancer is confirmed by use of precise
microscopic orientation. Mohs Micrographic Surgery has the highest cure rate for the most
common forms of skin cancer and minimizes loss of healthy skin. Mohs surgeons have
completed a 1 to 2 year certified surgical fellowship of the American College of Mohs
Micrographic Surgery and Cutaneous Oncology (ACMMSCO) www.acmmsco.org.
Mohs micrographic surgery is indicated for skin cancers that are large, recurrent or in
certain areas of the body where recurrences are likely (i.e. face, ears, lips, nose,
scalp). It is also indicated for certain aggressive types of skin cancers.
Mohs surgery is performed on an outpatient basis, under local anesthesia.
How Mohs surgery is performed
Rationale: The roots of a skin cancer may extend beyond the visible portion of the
tumor. If these roots are not removed, the cancer will recur.
- Step 1: The visible portion of the tumor is surgically removed.
- Step 2: A layer of skin is then removed and divided into sections. The surgeon
then color codes each of these sections with dyes and makes reference marks on the skin to
show the source of these sections. A map of the surgical site is then drawn.
- Step 3: The undersurface and edges of each section are then microscopically
examined for evidence of remaining cancer.
- Step 4: If cancer cells are found under the microscope, the surgeon marks their
location on the "map" and returns to the patient to remove another layer of skin
- but only precisely where the cancer cells remain.
- Step 5: The removal process stops when there is no longer any evidence of cancer
remaining in the surgical site. Because Mohs surgery removes only tissue containing
cancer, it ensures that the healthy tissue is kept intact.
Follow up after the Mohs surgery.
After the removal process is complete the Mohs surgeon will discuss the options for
repairing of the wound. The most often used are direct closure, skin flaps, skin grafts
and second intention. These repairs are usually done on the same day, however, in some
cases, the repair may be delayed until the next day. In some instances, you would be
referred to a plastic surgeon for repair.
Since all skin cancers do not require Mohs surgery, referral for this procedure through
a dermatologist or other physician is encouraged. |