The Mohs Micrographic Surgery Process
Mohs surgery is usually an outpatient procedure performed in a physician’s office. Typically, it starts early in the morning and can be 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, so the patient is awake during the entire procedure.
Mohs Micrographic surgery is the most advanced and effective treatment procedure for skin cancer. The procedure is performed by specifically trained surgeons who have completed at least one additional year of fellowship training (in addition to the physician’s three-year dermatology residency) under the tutelage of a Mohs College member. Initially developed by Dr. Frederic E. Mohs procedure is a state-of-the-art treatment that has been continually refined over 70 years. With the Mohs technique, physicians are able to see beyond the visible disease, to precisely identify and remove the entire tumor layer by layer while leaving the surrounding healthy tissue intact and unharmed. As the most exact and precise method of tumor removal, it minimizes the chance of re-growth and lessens the potential for scarring or disfigurement. Because the physician is specially trained in surgery and pathology, Mohs surgery has the highest success rate of all treatments for skin cancer – up to 99%. The Mohs technique is also the treatment of choice for cancers of the face and other sensitive areas as it relies on the accuracy of a microscopic surgical procedure to trace the edges of cancer and ensure complete removal of all tumors.
The roots of skin cancer may extend beyond the visible portion of the tumor. If these roots are not removed, the cancer will recur.
The visible portion of the tumor is surgically removed.
A layer of skin is removed and divided into sections. The ACMS 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.
The undersurface and edges of each section are microscopically examined for evidence of remaining cancer.
If cancer cells are found under the microscope, the ACMS surgeon marks their location onto the “map” and returns to the patient to remove another layer of skin- but only from precisely where the cancer cells remain.
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 maximum amount of healthy tissue is kept intact.