Mohs Surgery Day

What to expect during your Mohs surgery appointment.

Our nurses will bring you to our surgical suite. Together, we will identify and confirm with you the locations of the tumors. Next, the area is numbed around the tumor using local anaesthesia to eliminate pain. This usually stings for a few seconds but is usually the only pain felt throughout the whole procedure.

The visible portion of the tumor is then carefully removed using a scalpel or curette.

The next step is to remove a layer of tissue to check the margins for the presence of tumor. A 1-3mm margin around the tumor is drawn and a thin pancake-shaped piece of tissue is removed using a sharp scalpel.

We then bring this tissue to the laboratory, process it, and make slides. This slide making process may take several hours and during this time, a bandage is placed on your wound and you may be brought to the waiting room area to await the results.

When the slides are ready, our doctors then examine both the lateral and deep margins of the tissue with a microscope and check for tumors. The results of this step are plotted on a map of the treatment area.

If there is any tumor left in any section, you are brought back to the surgery room, and another tissue layer is taken, to again check the margins for tumor. This process is repeated until the base and sides of the tumor no longer contain tumor cells and the cancer is totally removed. It usually takes most patients 2-3 stages to clear a tumor, with each stage taking approximately 2-3 hours. Occasionally, it can take 4-5 or more stages to clear the tumor. Sometimes, but rarely, we are not able to complete clearing the tumor in one day and may have you come back the following day to continue the Mohs Surgery procedure.

Once the surgery is complete, our nurses will give you written and verbal instructions on how to care for your wound. If prescriptions for antibiotics or pain medications are indicated, you will receive them at this time.

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