MOHS Micrographic Surgery
MOHS Micrographic Surgery is a precise tissue-sparing technique for the removal of skin cancers that was developed in the 1960's by Dr. Frederick Mohs at the University of Wisconsin. Performed under local anesthesia, it offers the highest potential cure rate ( 99%), as well as superior cosmetic results, as the least amount of tissue is removed. A unique characteristic of this procedure is that the physician, because of the specialized type of training that is required to master it, serves as surgeon, pathologist and reconstructive surgeon.
The Procedure begins with Dr. Shah removing what visibly appears to be the entire tumor as well as a small amount of normal surrounding skin. The patient is then escorted to the waiting room while the specimen is microscopically processed by her laboratory technician and analyzed by Dr. Shah to determine if any tumor remains along its perimeter or deep surface. If tumor is detected, another specimen is removed and similarly processed and analyzed. The extent of the tumor may require that this sequence be repeated several times. When it has been determined that all margins are tumor free, Dr. Shah will discuss the type of repair, if any, that is required, and provide it. Choices include a simple closure with sutures, a flap or graft type procedure, as well as no repair at all, i.e. allowing the wound to heal without suturing.
The number of layers that are removed, and the type of repair that is required, will determine the length of time a patient spends in the office. This ranges from a minimum of 2 hours to half a day.
Patient Selection is important, as MOHS Surgery is by no means the appropriate procedure for all skin cancers. It is however the treatment of choice for certain types of sun-induced skin cancers such as basal cell carcinoma, squamous cell carcinoma, and some melanomas, as well as other unusual types of growths, if they meet certain specific criteria. These include cosmetically sensitive or functionally critical locations around the eyes, nose, lips and ears, large-size, rapid growth, poorly defined edges, recurrence, and unusual microscopic characteristics upon initial biopsy.
Our Nursing and Clerical Staff
Our Nursing and Clerical Staff consists of a dedicated team of approachable individuals who are attuned to the concerns and needs of patients requiring this special type of surgery. They will facilitate all aspects of the procedure, from scheduling the appointment, to making the surgical visit as comfortable as possible, to providing appropriate education in post -operative care . Our technical staff consists of individuals who are exceptionally skilled in the important process of preparing tissue specimens so that Dr. Shah may appropriately analyze them.
Our Surgical Facility
Our Surgical Facility occupies a modern suite of offices physically independent from the Dermatology Associates' offices. With 4 operating rooms, a state-of-the-art pathology laboratory, and a waiting room that provides comfortable seating, music, TV, beverages and snacks, we feel that we have created an environment that is conducive to the specific needs of patients requiring this special type of surgical procedure.