Mohs skin cancer surgery
‘The “Gold Standard” surgical method used worldwide for the most effective removal of skin cancers is Mohs surgery, which went through an extensive process of development in the United States of America,’ says Dr Pieter du Plessis, who is based at the Club Surgical Centre in Hazelwood, Pretoria.
Mohs surgery is an economical, precise and sophisticated technique that eradicates skin cancers.
‘What is critical about skin cancer is that you must get rid of it completely, to minimise any chance of recurrence, and Mohs surgery does just that. After Mohs surgery you can assure the patient that the margins around the cancer is free of tumour,’ he says.
how is mohs surgery performed?
With the Mohs Surgery technique, performed in most cases under a local anaesthetic, the tumour is removed with a thin layer of surrounding healthy tissue. The removed tissue is then processed immediately by the Mohs surgeon in a Mohs histological laboratory on site, while the patient returns to the ward. See Mohs Surgery in pictures.
The specific method of processing allows tissue slides to be produced that shows the whole, complete cut surface around the tumour. These slides are then examined by the Mohs surgeon and will show very accurately any remaining tumour, including the exact area on the tumour wound where tumour is still present.
The patient then returns to the day theater and process is repeated, but only on the area of remaining tumour, leaving the healthy tumour-free part of the wound alone. As soon as the Mohs surgery confirms the skin cancer to be completely removed, a specialist reconstructive surgeon or the Mohs surgeon repairs the defect where the cancer was removed almost always on the same day.
Mohs Micrographic Surgery is not required for the treatment of every skin cancer. Patients are seen for Mohs surgery by referral only.
The Skinmatters Mohs Micrographic Surgery unit functions as an extension of the referring medical practices. Referring practitioners successfully diagnose and treat the majority of skin cancer with the appropriate methods at their disposal, know the indications and criteria for Mohs Micrographic Surgery, and which patients to refer for this procedure.
Following successful Mohs Micrographic Surgery, all patients are referred back to the original referring practice, for subsequent follow-up and management of future skin disease.
Club Surgical Center
Nestled in the quiet suburb of Hazelwood lies the Club Surgical Center, an ultra-modern specialist day hospital where world class procedures and treatments for skin cancer are offered. The Club Surgical Center is a facility of excellence and offers cutting edge treatment in skin cancer. We are the home of the Skin Matters, Mohs and Reconstruction Unit. Mohs Surgery is a microscopically controlled surgical procedure used to treat skin cancer and was pioneered by American surgeon Dr. Frederick Mohs. Let us give you a glimpse into the international gold standard treatment for skin cancer, the technique known as Mohs Micrographic Surgery.
On the day of your consultation in our rooms on the second floor, you will visit the dermatologist who will be assigned to perform the Mohs surgery. The experience is intended to be informative and reassuring so that you know exactly what to expect on the journey ahead. You will be warmly welcomed by our reception staff into a professional and supportive environment. Mohs specialists Dr. Peter Du Plessis, Dr. Nivana Ramlachan or Dr. Tsepo Mokwena take you to their consulting rooms where they will explain the Mohs procedure in detail, answer all your most pressing questions and book a suitable theatre date for you.
Your booking will be confirmed, and you will leave our rooms feeling positive about the upcoming treatment. Knowing that Mohs surgery provides the highest cure rate of all available skin cancer treatments. You will then return to the hospital reception for a short pre-admission process. After this, our efficient practice staff will contact your medical aid and arrange pre-authorization for the Mohs procedure. Theatre lists are set up and communicated to all key role players. Prior to the day of the operation, you will be contacted and provided with a time of admission, along with all the information you need on how to prepare for the day.
On the actual day of surgery, you will be welcomed by our friendly reception staff who will admit you into the hospital, leaving you in the capable, caring hands of our nursing team. In the recliner ward every effort will be made to ensure that you are comfortable and are able to relax, knowing that you are receiving the best possible care. From there, you will be taken to theatre where the skin cancer will be excised with the Mohs technique under a local anaesthetic. Read more about the Mohs Histology procedure and animation.
After the procedure, you will return to the unhurried atmosphere of the recliner ward, and while you rest and recover, the excised tissue will be taken to the Mohs Micrographic onsite laboratory where it will be mapped and prepared for processing by our specialist laboratory team. The process itself is a marvel of modern medicine and begins when a tissue block is embedded in Cryo-gel, ready for freezing. The freezing of the tissue block is achieved by using a state-of-the-art piece of equipment known as a Cryostat.
The frozen tissue block is then cut into thin wafers in the Cryostat by an experienced histotechnologist. The entire cut surface around the skin cancer is then examined microscopically for any remaining sign of skin cancer. It is this unique process that makes the Mohs Micrographic surgery the most accurate method of removing skin cancer. This process is then repeated until the entire tumour is removed from the excisional margins. The final phase of treatment is the closure and reconstruction of the post-operative site.
This procedure is usually performed on the same day by a specialist reconstructive surgeon. The specialist reconstruction often requires light sedation or a local anaesthetic to facilitate a comfortable procedure. After successful completion of the surgery and reconstruction, you will return to the recliner ward to enjoy a light snack and refreshments before being discharged. Mohs Micrographic Surgery and Reconstruction for indicated skin cancers is a one-day patient procedure performed by a dedicated world-class team of specialists at the Club Surgical Center. Your skin matters to us.
We are thus committed to curing skin cancer and in the vast majority of cases we do just that. See the Introductory video to Mohs Surgery by Dr. Pieter du Plessis.