Micrographic (Mohs’) Surgery
Information on Procedure Preparation
Micrographic surgery for skin cancer is the most reliable method of ensuring that a skin cancer is completely removed. While traditional methods for removal of skin cancer commonly achieve cure rates of 90-95%, micrographic excision produces cure rates of 96-99%. This method allows the surgeon to precisely remove cancerous tissue while sparing the maximal amount of non-involved normal surrounding skin.
This technique involves removing a narrow section of skin around the clinically evident tumor. The specimen is then “oriented” by utilizing tissue ink and notches at the edge of the specimen. Next the tissue is processed and multiple frozen sections are produced for the physician to examine microscopically. The unique method of tissue sectioning allows the physician to examine 100% of the tissue margin. This complete margin examination accounts for the extremely high cure rate of micrographic excision. If any residual tumor is noted at the periphery of the examined specimen, it is precisely “mapped” and the patient returned to the operative suite where more tissue is removed, oriented, and mapped. This process is continued until the tumor has been completely removed. When the tumor has been completely removed, the area is usually repaired the same day.
While this technique is more labor and time intensive than traditional methods, it is often the procedure of choice for many cancers present on the face. Recurrent tumors, unusual or aggressive cancers and large or poorly marginated lesions are also often best removed by micrographic excision.