What is Mohs Surgery?
Mohs surgery is an advanced technique where the physician serves as the surgeon, pathologist, and reconstructive surgeon. During the initial portion of the procedure, the surgeon removes a layer of skin around the visible portion of the tumor. Immediate microscopic examination of the tissue removed allows the surgeon to map out the skin cancer, beyond what is visible to the naked eye, and remove additional tissue from only the areas that are involved with the tumor. The removal process stops when there is no longer any evidence of cancer remaining in the surgical site.
The Mohs technique provides a 95% to 99% cure rate for all lesions treated. It removes only the tissue involved with the tumor, which minimizes the postoperative defect and results in a better cosmetic result.
What to Expect
The Mohs surgery procedure is done under local anesthesia. Photographs are taken before, during and after surgery. The majority of your time will be spent waiting for the slide preparation and interpretation. Once the tissue has been surgically removed, the wound is dressed with a temporary bandage and you will be escorted to a private waiting area to rest while the tissue is being processed. Our tranquil Mohs waiting area offers HDTV, Wifi, and a snack bar. The number of times you return to the surgical suite for removal of tissue is determined by the results of microscopic examination of the tissue. The tumor may require only one stage for complete removal or multiple stages. The surgery is continued until the tumor is completely removed by the microscopic examination. You should plan to spend the entire day in the clinic. The procedure may last from a couple of hours to several hours, rarely running into the next day.
History of Mohs Surgery
Mohs surgery was developed by Dr Frederic E. Mohs, whose pioneering work was performed at the University of Wisconsin in the 1930s and first published in 1941. Initially, Dr. Mohs removed tumors with a chemosurgical technique using zinc chloride. Thin layers of chemically fixed tissue were excised for pathological examination. He developed a unique technique of color-coding excised specimens and created a mapping process to accurately identify the location of remaining cancerous cells.
Over 30 years ago, the tissue-processing procedure for Mohs surgery evolved from a zinc chloride-based, fixed tissue technique to a fresh-frozen tissue technique, an innovation initially performed by Dr Mohs in 1953 but later described in detail by Tromovitch & Stegman in 1974. This innovation reduced the normal treatment time to one visit and allowed for immediate reconstruction of the wound. The heart of the procedure — the color-coded mapping of excised specimens and their thorough microscopic examination – remains the definitive and unique part of the Mohs surgical procedure.
