MOHS Surgery: Fundamentals and Techniques

Various modalities are employed for the treatment of cutaneous malignancies including cryotherapy, electrosurgery, excision and suture closure, radiation therapy, and Mohs micrographic surgery. The Mohs procedure combines surgery with pathological analysis of removed tissue to trace and ensure full elimination of skin cancer down to its roots. The goal of Mohs micrographic surgery is complete tunmour removal with maximal preservation of normal tissue. This guide contains details of the Mohs technique from basic to advanced. Topics covered include: office and laboratory set-up; surgical techniques; processing of the specimen into high-quality frozen section slides; and evaluation of the slides specimens.

Table of Contents:
1 History of Mohs Surgery and Mohs Training 2 Basic Mohs Technique 3 Indications for Mohs Surgery 4 Office and Laboratory Set-Up and Instrumentation for Mohs Surgery 5 Patient Preparation for Mohs Surgery 6 Mohs Surgical Techniques 7 Mohs Micrographic Surgery of Fat, Mucosa, Muscle, Nerve, Cartilage and Bone 8 Mohs Micrographic Surgery of Genitalia, Eyelids and Nails 9 Mohs Mapping 10 Specimen Transport and Preliminary Tissue Processing 11 The Cryostat and Cryostat Technique: Obtaining Quality Mohs Slides 12 Mohs Slides: Trouble Shooting and Quality Assurance 13 Staining and Coverslipping Mohs Slides 14 Special Stains Applicable to Mohs Surgery 15 Basic Approach to Interpreting Mohs Microscopic Slides 16 Normal Cutaneous Histology for Mohs Surgery 17 Basal Cell and Squamous Cell Carcinomas in Mohs Sections 18 Mohs Surgery for Unusual Tumors 19 Mohs Micrographic Surgery and Melanoma 20 Potential Pitfalls and Abuses of Mohs Surgery 21 Mohs Surgery for Large and Difficult Tumors and in Special Clinical Situations 22 When Not to do Mohs Surgery and What to do When Tumor Free Margins Are Not Attainable 23 Quality Assurance for Mohs Surgery 24 Fixed Tissue Mohs Surgery 25 Otolaryngology Perspective of Mohs Surgery 26 The Plastic Surgeon and Mohs Micrographic Surgery 27 The General Pathologist's Role in Mohs Surgery 28 Assessing Cancer Surgical Margins 29 Training Mohs Technicians 30 Mohs Cure Rates 31 Record Keeping and Documentation Edward H. Yob 32 CLIA and OSHA Regulations Pertaining to Mohs Surgery 33 Building a Mohs Surgical Practice and Networking with Other Specialists 34 Closure Considerations and Adjunctive Therapy After Mohs Surgery 35 Scheduling Mohs Surgery in the Office 36 Mohs Coding and Reimbursement Issues 37 A New Practitioner's Perspective of Mohs Surgery APPENDIXES A Sample Documents B Suppliers C Glossary of Selected Mohs Terms

About the Author :
Ronald P. Rapini, MD, born in 1954 in Akron, Ohio, is a renowned dermatologist and dermatopathologist. He is the Chernosky Professor and Chair of Dermatology at UTHealth Houston and MD Anderson Cancer Center. Trained at Ohio State, University of Iowa, and Colorado, he has led the growth of the dermatology program there since 2002, mentoring many award-winning trainees. He has served as president of major dermatology societies, authored the widely used textbook Practical Dermatopathology, and published over 150 peer-reviewed articles.