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. 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.

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What Is Happening While You Wait? ...

 

Prep Work :

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. If your skin cancer is on your face, that may mean you can’t see what’s happening, but the doctor talks you through it. The surgeon then injects a local anesthesia, 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, color codes them with dyes, and draws a map of the surgical site. In the lab, the histotechnician then 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.

 

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.