Mohs surgery, also known as chemosurgery, created by a general surgeon, Dr. Frederic E. Mohs, is microscopically controlled surgery used to treat common types of skin cancer. Mohs surgery allows for the removal of a skin cancer with very narrow surgical margin and a high cure rate.
The cure rate with Mohs surgery cited by most studies is between 97% and 99.8%for primary basal cell carcinoma, the most common type of skin cancer. Mohs procedure is also used for squamous cell carcinoma, but with a lower cure rate. It has been used in the removal of melanoma-in-situ (cure rate 77% to 98% depending on surgeon), and certain types of melanoma (cure rate 52%).
The characteristic symptoms of basal cell carcinoma are
How to prepare for Mohs Surgery
What to expect day of Mohs surgery
Our nurses will escort you to the surgery suite. You will be asked to change into a gown and at that time we will answer any last minute questions. Once you have entered the operating room, the staff will do everything they can to make you feel secure and comfortable.
Next the area is numbed around the tumor using local anaesthesia to eliminate pain. This stings for only a few seconds and is usually the only pain felt throughout the procedure. The tumor is then carefully removed using the scalpel.
The next step is to remove a layer of tissue to check to see the margins are clear of the tumor.
We then bring this tissue to the laboratory, process this tissue and make slides. This could take several hours and during this time, a bandage is placed on your wound while you await your results.
When the slides are ready, Dr Brown then examines both the lateral and deep margins of the tissue with a microscope. The results are then plotted on a map of the treatment area.
If there is still not a clear margin, you will be brought back into the surgery room where the surgeon will take another layer of tissue, to check for clear margins. This process is repeated until the margins of the tissue clear, with no tumor cells, which indicates the cancer is totally removed.
It is common for most patients to go 2-3 stages to clear a tumor, with each stage taking approximately 2-3 hours. Sometimes, but rarely the patient will have to return the following day to complete the repair.
Once Mohs surgery is complete, our nurses will give you written and verbal instructions on how to care for your wound. If prescriptions for antibiotics or pain medications are indicated, you will receive them at this time.