The Mohs Surgery Procedure
It's helpful to know what to expect before you undergo any surgical procedure. Because the Mohs surgery procedure for skin cancer removal is somewhat complex, it can be reassuring to become familiar with the process ahead of time. While Mohs surgery is highly effective, it is an intricate skin cancer treatment that requires time and patience.
Mohs surgery is the most effective treatment for most types of skin cancer. To learn more about your options, find a fellowship trained Mohs surgeon in your area.
Surgeons usually perform Mohs micrographic surgery as an outpatient procedure in their office, which will have an on-site surgical suite and a laboratory for immediate preparation and microscopic examination of tissue. Typically, surgery starts early in the morning and is completed the same day, depending on the extent of the tumor and the amount of reconstruction necessary.
Local anesthesia is administered around the area of the tumor as the patient is awake during the entire procedure. The use of local anesthesia in Mohs surgery versus general anesthesia provides numerous benefits, including the prevention of lengthy recovery and possible side effects from general anesthesia. After the area has been numbed, the Mohs surgeon removes the visible tumor along with a thin layer of surrounding tissue. This tissue is prepared and put on slides by a technician and examined under a microscope by the Mohs surgeon. If there is evidence of cancer, another layer of tissue is taken from the area where the cancer was detected. This ensures that only cancerous tissue is removed during the procedure, minimizing the loss of healthy tissue. These steps are repeated until all samples are free of cancer. (See the diagram ) While there are always exceptions to the rule, most tumors require 1 to 3 stages for complete removal.
When the surgery is complete, the Mohs surgeon will assess the wound and discuss options for ideal functional and cosmetic reconstruction. If reconstruction is necessary, the Mohs surgeon will usually perform reconstructive surgery to repair the area the same day as the tumor removal.