Types of Mohs Surgery

The main difference between mohs surgery and other skin cancer surgeries is that Mohs surgery spares as much healthy tissue as possible.

During Mohs skin cancer surgery, your skin cancer surgeon will:

• Remove a layer of tissue, and examine it under a microscope.
• If any cancer cells remain, the surgeon knows the exact area where they are and removes another layer of tissue from that precise location, while sparing as much healthy tissue as possible.
• The doctor repeats this process until no cancer cells remain.

In traditional melanoma surgery, the surgeon removes the visible cancer, in addition to a designated margin of normal skin around the skin lesion, depending on the thickness of the melanoma under the microscope. The skin specimen is processed in permanent sections and examined under a microscope to see if it has been completely removed. In Mohs surgery, the frozen sections are mapped out and examined by the dermatology surgeon under the microsopec as the procedure is performed. Additional surgery is done until all of the cancer is removed. Because melanoma cells may be difficult to see on routine stains under the microscope, Stanford Mohs surgeons use special stains (called immunostains) to help visualize the tumor during the procedure to ensure that it is completely removed.