Mohs surgery is considered the most effective technique for treating many basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), the two most common types of skin cancer.
It is sometimes called Mohs micrographic surgery. The procedure is done in stages, including lab work, while the patient waits. This allows the removal of all cancerous cells for the highest cure rate while sparing healthy tissue and leaving the smallest possible scar.
It begins with chemosurgery. Although it was not popular back then, Frederic E. Mohs, MD, practiced this in the late 1930s. Its potential was fully displayed by perry Robins in 1960.
Dr. Robins helped advance the procedure into what is now called Mohs surgery and went on to teach and promote it around the world.
What is Mohs Surgery?
Mohs surgery is a surgical technique that majors in dealing with skin cancer and other skin diseases. The process involves removing thin layers of cancer-containing skin until only cancer-free skin remains.
Furthermore, It can also be referred to as Mohs micrographic surgery. Its goal is to remove as much skin cancer as possible while doing minimal damage to surrounding healthy skin tissues.
The surgery is usually done on an outpatient basis using a local anesthetic.
Mohs surgery is an improvement to standard surgery (local excision), which involves removing visible cancer and a small margin of surrounding healthy tissue all at once.
In addition, it allows surgeons to verify that all cancer cells have been removed at the time of surgery. This increases the chance of a cure and reduces the need for additional treatments or additional surgery.
Why do Mohs Surgery?
This surgery is basically to treat the most common skin cancers, basal cell carcinoma, and squamous cell carcinoma, as well as some kinds of melanoma and other more unusual skin cancers.
This surgery can be performed by many dermatologists since they learn all about Mohs surgery in their medical training.
It is mostly for skin cancers that:
- Have a tendency for recurrence
- Are in areas where you want to preserve as much healthy tissue as possible, such as around the eyes, ears, nose, mouth, hands, feet, and genitals
- Areas that have borders that are difficult to analyze
- Spots that are large or aggressive.
Benefits of Mohs surgery
The advantages of Mohs surgery are numerous and its benefits outweigh its risks. Some of it’s benefits include:
- It is cost-efficient. The price is quite affordable
- Single-visit outpatient surgery
- Local anesthesia
- It is time efficient. Lab work is done on site
- Gives precise and accurate results
- It spares healthy tissue by focusing more on the cancer-prone parts
- Leaves behind little or no scars at all
- It has the highest cure rate
- Mohs surgery neutralizes up to 99% of skin cancers that have not been treated before
- Neutralizes up to 94% of skin cancers that have recurred after previous treatment
The Risks attached
Like all other medical surgeries, Mohs surgery has its own risk. Some of these risk includes;
- Tendency to feel Pain and soften tissue around the treated area
- Skin Infection
- Temporary or permanent numbness after surgery
- Itching or shooting pain
- There’s the possibility of having a permanent scar
Procedures for the surgery
Mohs surgery is done Mostly on outpatients. It is grounded in an operating room or procedure room that has a nearby laboratory which allows the surgeon to freely examine the tissues after removal.
Times, the procedure lasts a few hours but because of the difficulty in telling how extensive a skin tumor is, it often takes almost the whole day for the procedure to end.
Also, you might not need to change into a surgical gown unless the location of the tumor requires it.
- To prepare you for surgery, your nurse and surgeon must follow the protocols below;
- The area to be operated must be cleansed
- They must outline the area with a special pen and also inject it with a local anesthetic Which will numb your skin to prevent pain or discomfort.
During the procedure
- Once the anesthetic has taken effect, your surgeon uses a scalpel to remove the visible portion of cancer along with a thin, underlying layer of tissue that’s slightly larger than the visible tumor.
- A temporary bandage is placed on your incision. It’ll only a few minutes. The surgeon then takes this tissue to the laboratory for analysis.
- Your surgeon will track the spots where each piece of tissue was removed by making a map. This will give the surgeon a sense of direction.
- If cancer remains, your Mohs surgery will continue.
- Your surgeon removes an additional layer of tissue from the affected area, taking care to remove tissue that contains cancer while leaving as much healthy tissue as possible intact.
- The process is repeated until the last tissue sample removed is cancer-free. Local anesthetic can be re-administered as necessary.
After all of cancer has been removed, you and your surgeon can decide on how to repair the wound. It will depend on the extent of the operation, this may include:
- Natural healing; is letting the wound heal on its own.
- Secondly, The use of stitches to aid wound healing
- Thirdly, Use a skin flap to cover the wound.
- Making a skin graft from other parts of the body to cover the wound.
- Also, Your surgeon may temporarily close your wound and then refer you to another surgeon for reconstructive surgery to repair the wound if your wound is too extensive.
One of the major benefits of Mohs surgery is that you get to know your results almost instantly.
Apparently, you usually don’t get to leave until all of the skin cancer and diseases have been removed and treated properly.
Furthermore, a follow-up visit with your surgeon or referring doctor to monitor your recovery to make sure your wound is healing properly is quite necessary too.