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Mohs Surgery
What Is Mohs Surgery?
The procedure is done in stages, all in one visit, while the patient waits between each stage. After removing a layer of tissue, Dr. Glass examines it under a microscope in an on-site lab (this process can take around 1 hour). If any cancer cells remain, she 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. She repeats this process until no cancer cells remain. Once all the cancer is cleared, the wound defect will be sutured and closed to give the best cosmetic outcome.
What Is Happening While You Wait? ...
Prep Work :
Depending on the location of your skin cancer, you may be able to wear your regular clothes, or you may need to put on a gown. The site is examined where you had your biopsy and is marked with a pen for reference. You will be positioned to allow for the best access, which may mean sitting up or lying down. A surgical drape is placed over the area. If your skin cancer is on your face, that may mean you can’t see what’s happening, but the staff will talk you through it. The area is then injected with local anesthesia (typically lidocaine with epinephrine is used), which numbs the area completely. You stay awake throughout the procedure.
Top Layer Removal :
Using a scalpel, Dr. Glass removes a thin layer of visible cancerous tissue. Some skin cancers may be “the tip of the iceberg,” meaning they have roots or extensions that aren’t visible from the surface. The lab analysis, which comes next, will determine that. Your wound is bandaged temporarily and you can relax while the lab work begins.
Lab Work :
A Mohs histotechnician, who is someone specially trained to do this procedure, cuts the tissue into sections and color codes them with dyes. In the lab, the histotechnician then freezes the divided tissue, cuts it into very thin horizontal slices like a layer cake. The slices are placed on microscope slides, stained, and covered. This meticulous process takes time, usually around 1 hour.
Microscopic exam :
Using a microscope, Dr. Glass examines all the edges and underside of the tissue on the slides and, if any cancer cells remain, marks their location on the map. Dr. Glass then lets you know whether you need another layer of tissue removed. If more than one or two rounds are needed, the entire process can take up to several hours, so be prepared for that. It’s worth it though, because this precise technique has the highest cure rate. This can save the greatest amount of healthy tissue, leaving the smallest scar possible. Carefully follow your instructions for wound care, scar care, and follow-up to achieve the best outcome.
