MOHS MICROCOPIC SURGERY

What is Mohs Micrographic Surgery?

Mohs Microscopic Surgery is the most advanced and effective surgical procedure for skin cancers available today.

Initially developed by Dr. Frederic E. Mohs, the Mohs procedure is a state-of-the-art treatment that has been continuously refined over 70 years. With the Mohs technique, surgeons 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.

Mohs Microscopic surgery has the highest success rate of all treatments for skin cancer - up to 99 percent.

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 the cancer and ensure complete removal of all tumors down to the roots during the initial surgery.

What are the indications of Mohs Micrographic Surgery?

Mohs Surgery is appropriate when:

• the cancer is in an area where it is important to preserve healthy tissue for maximum functional and cosmetic result, such as eyelids, nose, ears, lips, fingers, toes, genitals;
  
  
• the cancer was treated previously and recurred;
  
  
• scar tissue exists in the area of the cancer;
  
  
• the cancer is large;
  
  
• the edges of the cancer cannot be clearly defined;
  
  
• the cancer is growing rapidly or uncontrollably.

What happens at the time of Mohs Surgery?

Mohs surgery is usually an outpatient procedure performed in the doctor’s surgery.

Typically, it starts early in the morning and can be completed the same day, depending on the extent of the tumor and the amount or reconstruction necessary. Sometimes, there is a 24 hour delay in repairing the surgical defect.

Local anesthesia is administered around the area of the tumor and the patient is awake during the entire procedure, without any discomfort.

What happens at the time of Mohs Surgery?

Step 1: Surgical removal of the visible cancer.

Step 2: Immediate histological examination of the excised skin cancer specimen by a histopathologist.

Step 3: Immediate interpretation of microscope slides (Pathology). If the excised specimen does not contain the WHOLE skin cancer, then the pathologist conveys this information to Dr Kim. Dr Kim will then remove more skin which is then re-examined by the histopathologist. Once there is histological confirmation of “WHOLE” skin cancer removal, then Dr Kim will proceed to Step 4.

Step 4: Reparing of the surgical defect. The resulting surgical defect, once there is a confirmation of complete skin cancer removal, is then repaired using an appropriate surgical technique. It may be closed using a simple closure or a more complex flap or graft repair, depending on individual cases.

Advantage of Mohs Surgery is that the surgeon has a proof that there is no skin cancer left behind at the time of surgery, and that a maximum amount of normal skin cancer be conserved so that the reconstruction can be more easy and cosmetically satisfying.