Extended Mohs surgery for Malignant Melanom [Video]

Mohs surgery, named after Dr. Frederick Mohs who pioneered the technique in the 1930s, is a specialized surgical procedure primarily used to treat skin cancer, particularly basal cell carcinoma and squamous cell carcinoma. It is known for its high cure rates and preservation of healthy tissue. Here’s an overview of how Mohs surgery works:

Initial Examination: Mohs surgery begins with a thorough examination of the suspicious skin lesion or tumor by a dermatologist. This examination may include a visual inspection, biopsy, and possibly imaging tests to determine the extent and depth of the cancerous cells.
Local Anesthesia: Before the surgery begins, local anesthesia is administered to numb the area surrounding the tumor. This ensures that the patient remains comfortable during the procedure.
Tumor Removal: The surgeon begins by carefully removing the visible portion of the tumor using a scalpel. The goal is to excise as much of the cancerous tissue as possible while preserving as much healthy tissue as possible.
Tissue Mapping: After the visible tumor is removed, the surgeon creates a detailed map or diagram of the surgical site, marking the location of any remaining cancerous cells that may not be visible to the naked eye.
Tissue Examination: The excised tissue is then processed and examined under a microscope in an on-site laboratory. The surgeon evaluates the margins of the tissue to determine if any cancerous cells remain at the edges. This process typically takes about 30-60 minutes.
Further Removal (if necessary): If cancerous cells are found at the margins of the excised tissue, the surgeon will return to the patient and remove another layer of tissue from the specific areas where cancer cells were identified. This process is repeated until the margins are clear of cancer cells, minimizing the removal of healthy tissue.
Closure: Once the surgeon confirms that the margins are clear of cancer cells, the wound is closed using various techniques such as sutures, skin grafts, or flaps. The goal is to achieve optimal cosmetic results while ensuring proper wound healing.
Pathology Examination: After the procedure is complete, the excised tissue is further examined by a pathologist to confirm the absence of cancer cells and ensure that the tumor has been completely removed.
Mohs surgery offers several advantages over traditional surgical techniques, including:

High cure rates, with up to 99% for certain types of skin cancer.
Preservation of healthy tissue, which is particularly beneficial for tumors located in cosmetically sensitive areas such as the face.
Minimization of scarring and potential for recurrence.
Ability to complete the procedure in a single visit for many patients.
Overall, Mohs surgery is a highly effective and precise technique for treating skin cancer, offering patients the best chance for complete tumor removal while minimizing the impact on healthy tissue and achieving optimal cosmetic outcom