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  The Mohs Surgical Procedure
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Typically, Mohs surgery is performed as an outpatient procedure
in the physician's office. Although the patient is awake during
the entire procedure, discomfort is usually minimal and no
greater than it would be for more routine skin cancer surgeries.
The Mohs surgical procedure is illustrated in the following
diagrams:		  
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The area to be treated is cleansed, marked,
and injected with a local anesthetic.The Mohs
surgeon removes the visible cancer, along
with a thin layer of additional tissue (Stage I).
This procedure takes only a few minutes, and
the patient waits while tissue is being processed
and examined.
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The removed tissue specimen is cut into sections,stained, and marked on a detailed diagram (Mohs map).
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Tissue is frozen on a cryostat, and technician removes very thin slices from the entire edge and undersurface. These slices are then placed on slides and stained for examination under the microscope. (This is the most time-consuming portion of the procedure, often requiring one hour or more to complete.)
The Mohs surgeon carefully examines the entire undersurface and complete edge of the specimen, and all microscopic "roots" of the cancer are precisely identified and pinpointed on the Mohs map.Upon microscopic examination, if residual cancer is found, the Mohs surgeon utilizes the Mohs map to direct the removal of additional tissue. Note that additional tissue is removed only where cancer is present.
This process is repeated as many times as
necessary to locate any remaining cancerous areas within the tissue specimen

When microscopic examination reveals that there is no remaining tumor, the surgical defect is ready
for repair.
Read about how you should prepare for Mohs Surgery...
 

Courtesty of the American Society of Mohs Surgery
www.mohrssurgery.org