How is Mohs Surgery performed?

MOHS micrographic surgery (MOHS surgery) is a specialized technique for removing skin cancer that involves removing the cancerous tissue layer by layer and examining each layer under a microscope.

The MOHS Surgery procedure typically entails the following steps:

  1. Local anaesthesia: The procedure is typically performed under local anaesthesia, which numbs the area around the cancer and keeps the patient awake and alert during the surgery.
  2. Removal of the cancerous tissue: The surgeon will remove the visible cancerous tissue along with a small margin of healthy tissue surrounding it. The tissue is then prepared for examination under the microscope.
  3. Examination of the tissue: The removed tissue is examined by a MOHS histotechnician under a microscope to look for cancer cells. The histotechnician will look for cancerous cells that have not yet been removed in the tissue.
  4. Removal of additional tissue: If cancerous cells are still present in the tissue, the surgeon will remove additional layers of tissue surrounding the cancer in the precise location where the cancer cells were found. This process is repeated until all cancerous cells are removed.
  5. Closure of the wound: Once all the cancerous cells have been removed, the wound is closed using sutures, skin flaps or skin grafts, depending on the size and location of the wound.
  6. Follow up care: The patient will be scheduled for follow-up appointments with the surgeon to ensure that the cancer has not recurred and that the wound is healing properly.

The entire procedure can take several hours, as the surgeon will keep removing and inspecting layers of tissue until no cancer cells are found. The number of stages required will depend on the size and complexity of the cancer, in some cases it might take up to several stages to completely remove the cancer cells.

It’s worth mentioning that the procedure, although considered very accurate, may have some potential side effects or complications like bleeding, infection, numbness, and changes in pigmentation or sensation. The patient should discuss with the surgeon about possible complications, recovery and after care.