What is Mohs surgery?
Also called Mohs micrographic surgery. Used to treat skin cancer, this surgery has a unique benefit. During surgery, the surgeon can see where the cancer stops. This isn’t possible with other types of treatment for skin cancer. The ability to see where the cancer stops gives Mohs (pronounced Moes) two important advantages: Mohs has a high cure rate. Mohs surgery is considered the most effective technique for treating many basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), the two most common types of skin cancer. Sometimes called Mohs micrographic surgery, the procedure is done in stages, including lab work, while the patient waits. This allows the removal of all cancerous cells for the highest cure rate while sparing .
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 treatment process ahead of time. Here, you can learn what to expect before, during, and after your procedure.
Mohs surgery is the most effective treatment for most types of skin cancer. To learn more about ia options, find a fellowship trained Mohs surgeon in your area. When you meet with a surgeon certified by the American College of Mohs Surgery ACMS for a consultation, you determine together whether a Mohs surgical procedure is the best course of action for your cancer. Once you have set an appointment for surgery, you receive a detailed list of instructions to follow beforehand.
You may be asked to:. Procefure ACMS surgeon and his or her team will give you more information about these and other considerations before your surgery, and wha important to follow this advice as closely as you can to ensure a successful outcome. Surgeons usually perform Mohs skin cancer surgery as an outpatient procedure in the office, which has an on-site surgical suite and a laboratory for microscopic examination of tissue. Typically, surgery starts early in the morning iw is completed the same day, depending on the extent of the tumor and procdeure amount of reconstruction necessary.
You receive mkhs anesthesia around the area of the tumor, so you are awake during the entire procedure.
The use of local what is triton x- 100 versus general anesthesia provides numerous benefits, including preventing a lengthy recovery and possible side effects from general anesthesia. You are completely numb in the area of the surgery, though, so the procedure is comfortable. After sjrgery area has been numbed, your ACMS surgeon removes the visible tumor, along with a thin layer of surrounding tissue.
A ptocedure then prepares this tissue and puts it on slides for your what is mohs surgery procedure to examine under a microscope. If the surgeon sees evidence of cancer around the outer edges of the removed tissue, he or she takes another layer of tissue 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. Your surgeon repeats these steps until all samples are free of cancer.
Although there are always exceptions to the rule, most tumors require 1 to 3 stages for complete removal. To get a better picture of how this process takes place, please view our guide, The Mohs Step-by-Step Process. When your surgery is complete, your Mohs surgeon assesses the wound and discusses procedue options for ideal functional and cosmetic reconstruction.
ACMS surgeons understand that a good cosmetic result is an important part of the recovery process, and that's why they mohhs so hard to leave as little tissue damage as possible.
If reconstruction is necessary, the Mohs surgeon usually repairs the area the same day as the tumor removal. Learn more about Mohs surgery recovery, your reconstruction optionsand post-operative care. About Mohs Surgery.
Why it's done
Jun 05, · Mohs surgery is a painstaking procedure. It requires microscopic analysis of tissue cells while the surgery is taking place. The borders of each thin layer of tissue are analyzed for potential Author: Corey Whelan.
Mohs surgery is considered the most effective technique for treating many basal cell carcinomas BCCs and squamous cell carcinomas SCCs , the two most common types of skin cancer. Sometimes called Mohs micrographic surgery, the procedure is done in stages, including lab work, while the patient waits.
This allows the removal of all cancerous cells for the highest cure rate while sparing healthy tissue and leaving the smallest possible scar. It began as a technique called chemosurgery , developed by Frederic E.
Mohs, MD, in the late s, but was not widely known. Mohs, and recognized that it had great potential for the field of dermatology. He brought the technique to NYU, where he established the first fellowship training program to teach dermatologists this skin cancer surgery.
Robins helped advance the procedure into what is now called Mohs surgery and went on to teach and promote it around the world. Mohs surgery is performed by doctors who are specially trained to fulfill three roles:.
The procedure is done in stages, all in one visit, while the patient waits between each stage. After removing a layer of tissue, the surgeon examines it under a microscope in an on-site lab.
If any cancer cells remain, the surgeon knows the exact area where they are and removes another layer of tissue from that precise location, while sparing as much healthy tissue as possible.
The doctor repeats this process until no cancer cells remain. Depending on the location of your skin cancer, you may be able to wear your street clothes, or you may need to put on a hospital gown. The Mohs surgeon examines the spot where you had your biopsy and may mark it with a pen for reference. The doctor positions you for best access, which may mean sitting up or lying down. A surgical drape is placed over the area. The surgeon then injects a local anesthesia, which numbs the area completely.
You stay awake throughout the procedure. Using a scalpel, the surgeon removes a thin layer of visible cancerous tissue. The lab analysis, which comes next, will determine that. Your wound is bandaged temporarily and you can relax while the lab work begins.
The surgeon cuts the tissue into sections, color codes them with dyes and draws a map of the surgical site. In the lab, a technician freezes the divided tissue, then cuts very thin horizontal slices like a layer cake.
The slices are placed on microscope slides, stained and covered. This meticulous process takes time. Using a microscope, the surgeon examines all the edges and underside of the tissue on the slides and, if any cancer cells remain, marks their location on the map. The physician then lets you know whether you need another layer of tissue removed.
Back in the operating room, the surgeon injects more anesthesia if needed and removes another layer of skin, precisely where the cancer cells remain, based on the map.
Then, while you wait, the lab work begins again. This entire process is repeated as many times as needed until there are no more cancer cells. Once the site is clear of all cancer cells, the wound may be left open to heal or the surgeon may close it with stitches. This depends on its size and location.
In some cases, a wound may need reconstruction with a skin flap, where neighboring tissue is moved into the wound, or possibly a skin graft. In some cases, your Mohs surgeon may coordinate the repair of your wound with another specialist such as a plastic surgeon, oculoplastic surgeon or hand surgeon. In most instances, however, the Mohs surgeon will repair the wound immediately after obtaining clear margins. If more than one or two rounds are needed, the entire process can take up to several hours, so be prepared for that.
Mohs surgery is the gold standard for treating many basal cell carcinomas BCCs and squamous cell carcinomas SCCs , including those in cosmetically and functionally important areas around the eyes, nose, lips, ears, scalp, fingers, toes or genitals. Mohs is also recommended for BCCs or SCCs that are large, aggressive or growing rapidly, that have indistinct edges, or have recurred after previous treatment. Some surgeons are also successfully using Mohs surgery on certain cases of melanoma. Get more information about Mohs surgery.
Getting ready for the procedure. Find a fellowship-trained Mohs surgeon. More about Mohs surgery. Who performs the procedure? Mohs surgery is performed by doctors who are specially trained to fulfill three roles: as the surgeon who removes the cancerous tissue as the pathologist who analyzes the lab specimens as the surgeon who closes or reconstructs the wound. Advantages of Mohs surgery. What happens during Mohs surgery. Step 1: Examination and prep Depending on the location of your skin cancer, you may be able to wear your street clothes, or you may need to put on a hospital gown.
Step 2: Top layer removal Using a scalpel, the surgeon removes a thin layer of visible cancerous tissue. Step 3: Lab analysis The surgeon cuts the tissue into sections, color codes them with dyes and draws a map of the surgical site.
Step 4: Microscopic examination Using a microscope, the surgeon examines all the edges and underside of the tissue on the slides and, if any cancer cells remain, marks their location on the map. Step 5: Second layer removal Back in the operating room, the surgeon injects more anesthesia if needed and removes another layer of skin, precisely where the cancer cells remain, based on the map.
Step 6: Wound repair Once the site is clear of all cancer cells, the wound may be left open to heal or the surgeon may close it with stitches.
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