Mohs surgery is a surgical technique that precisely removes cancerous skin, layer after layer, while examining the tissue. It is an improvement to local excision, whereby a surgeon removes visible cancer and a small margin of surrounding healthy tissue. Mohs surgery aims to remove as much of the cancerous skin as possible while minimizing damage to the surrounding healthy tissues. During the procedure, your Mohs skin cancer surgeon Stockton removes and examines thin layers of skin affected by cancer until only healthy tissue remains.
Preparing for Mohs surgery
Like any other surgical procedure, an initial consultation is necessary before the procedure. During a consultation, you learn about the details of the process, and you can ask your provider any questions related to the treatment. Your surgeon may send you home with pre-operative instructions that you need to comply with. For example, you may need to stop taking blood-thinning medications and supplements to avoid excessive bleeding after surgery. You can continue taking prescription medications as instructed unless your surgeon says otherwise.
You may need to set aside an entire day for the procedure because it is not possible to predict how long surgery will take. In most cases, Mohs surgery lasts a few hours, but an extensive tumor can take longer. Since it is difficult to tell how extensive a cancer is by looking at the surface, you may need to plan as though surgery will take all day. You also want to wear comfortable clothing and dress in layers so you can adapt whether the room is warm or cold. Carry something like a book or magazine to help pass the time during Mohs surgery.
What to expect during Mohs surgery
Mohs surgery is usually an outpatient procedure; it is performed in a room close to a laboratory for the surgeon to examine the tissue after removal. Most people remain in their casual clothes, but you may need to change into a surgical gown depending on the tumor’s location. Your surgeon cleans the skin surface to be operated on, outlines the area with a special pen, and injects a local anesthetic. The anesthetic numbs your skin so you will not feel pain or discomfort during surgery.
After the numbing medication has taken effect, the surgeon uses a scalpel to remove the visible part of the cancer and a thin underlying layer of tissue. The surgeon takes the tissue to the laboratory for analysis; meanwhile, a temporary bandage is placed on the incision. Examining the tissue takes the most time; you may wait an hour or more before the surgeon returns. You are free to use the restroom or have a snack during this time, but you cannot leave the operating room until the procedure is complete.
The surgeon or a technician examines the tissue with a microscope as you wait. The surgeon makes a map to track the exact spot where each tissue was removed to know precisely where to continue the surgery. If there is still cancer, the surgeon cuts another skin layer and examines the tissue in the lab. The surgeon does this until the last examined tissue is cancer-free.
If you have any questions about Mohs surgery, consult your specialist at LUX Dermatology.