Mohs surgery (3D histology)
3D histology is a technique used in the treatment of skin cancer. It is characterized by a precise removal of lesions as a result of controlling all margins of the removed tissues. This allows to have a precise insight into the microscopic structure of tissues and enables radical excision of malignant cancerous lesions, simultaneously sparing a maximum amount of healthy tissues. That is why this method is characterized by the highest cure rates (95-98%).
There are two aspects which distinguish this method from the traditional surgery. Firstly, it is more complete as the examination refers to the entire area of surgical excision. Secondly, it is carried out with the use of intraoperative tactics and each step of the surgical procedure directly depends on the histological results.
First of all, doctors create what may be called a map of the tumor, assess its character and margins and check in what directions it grows. This consists in a microscopic assessment of thin sections of the lesion in order to detect cancer cells. In those places margins are trimmed. Mapping of the tumor is a process: excision and examination, another excision and examination. The process repeats till the end, that is until oncological cleanliness is achieved. However, everything is organized and coordinated in such a manner that the whole procedure is over within several days, at the most.
The technique of alternate excision of the lesion and microscopic examination has two major advantages. First of all, there is no need to guess how deep the excision is going to be; at the same time the risk of removing healthy tissue is minimized. As a result of such procedure - after the removal of a tumor, the margin of which is often irregular and marked out in different directions - a cavity is formed, its size and shape depending on the local area of “neoplastic infiltrations.” Thus, doctors remove only those fragments which they find it necessary to remove. Secondly, it decreases the likelihood of leaving neoplastic cells, which explains the high effectiveness of treatment with the use of the three-dimensional histology.
After the absence of neoplastic infiltrations is confirmed the wound is closed by means of one of the numerous methods of plastic surgery. Thanks to this procedure the scar from the disease is as esthetic as possible, which is of outmost importance as skin neoplasms are usually situated in places exposed to the UV radiation – face, neckline, back, shoulders. It is worth emphasizing that such surgery is not supplemented by other methods of treatment because it is not necessary.