Mohs surgical unit (Mohs)

“Many patients come to me full of concerns about their tumors, the risk of the tumor, and no less, how they will look after surgery. Mohs surgery by skilled hands will put any such concerns at rest.

There are some principles to guide me in Mohs and facial reconstruction surgeries. First and foremost, complete removal of the tumor, and then, but no less important, reconstruction of the surgical area while maintaining the principles of functionality, symmetry and aesthetics of the face.
During all steps, starting with the appointment at the clinic, throughout the surgery and the subsequent follow ups, I consider the cooperation and enrollment of the patient to the process, as an integral part of the surgical procedure we undergo together. The patient is a full partner in all the surgical and reconstructive decisions."
So says Dr. Galit Avinoam-Dar, director of the surgical Mohs and facial reconstruction unit at the Department of Plastic Surgery at Sheba Tel Hashomer Hospital and leader of the Mohs surgery unit at TLV Medical.
What else is important for you to know about undergoing the procedure with us? Here are the details. Mohs surgery

What is Mohs surgery?

Mohs surgery constitutes at the present the most advanced and effective method to treat skin cancer of the BCC (Basal cell carcinoma) type and- SCC (Squamous cell carcinoma), superficial spreading melanoma and other types of skin cancer tumors. 
This treatment method – named after Dr. Frederick Mohs who developed it – is unique – its uniqueness lies in the ability to perform microscopic examination and pathological analysis during the procedure itself.
Surgeries performed using this method are directed at tumors in the facial area, around the ears and the scalp.

תמונה של חלק מתהליך של ניתוח מוז - TLV MEDICAL

Mohs method - advantages

The largest and most significant advantage of the method is the ability to completely remove the tumor from its root, without harming the healthy skin tissue around it, that is, the aesthetics and function of the organ are preserved. 
In fact, this is the only method where it is possible to guarantee that 100% of the cancerous tissue margins have been removed – and accordingly prevent the tumor recurrence.
In other words: Mohs surgery allows for maximum healing, preservation of most of the healthy skin tissue and an aesthetic outcome.

What types of tumors is the Mohs method suitable for?

  • Tumor with unclear margins
  • A relapsing tumor following surgery or treatment.
  • A known tumor with a high probability of relapsing
  • A tumor located in the facial area where it is necessary to preserve healthy skin for reconstruction without aesthetically damaging the facial features following the tumor excision.

Mohs surgery – Treatment procedure

Surgery using the Mohs method is performed under operated area local anesthesia.
The next step in the process is the removal of the tumor within the approximate margins and the removal of another tissue layer that is invisible to the eye. 

While in process, the removed tissue is sent to the Mohs laboratory adjacent to the operating room.
The pathological examination, performed under a microscope and by a Mohs technician with special and specific training – the tumor metastatic growths are identified, if these exist, and their location is marked on a Mohs map. If there are tumor residues beyond the removed tissue, another removal of the tissue with the residues of the tumor remain will be performed.
The surgery is only completed when the microscopic examination indicates that the tumor tissue has been completely removed.

In some situations, the surgical wound does not heal naturally, so in quite a few cases, a follow-up procedure is necessary, which purpose of is to repair and close the surgical wound.
An average Mohs surgery may take between 2-4 hours, however, as it is difficult to estimate in advance the degree of tumor spread, so one has to prepare for a full day day.

Mohs surgery - recovery

Some pain is expected in the first few hours following surgery, these can be treated with pain killers.
In most cases the surgical wound heals within 3 weeks from the surgery, however, some surgery locations and scars may take longer to heal, a slow healing process that might take up to two years from the surgery.

Mohs surgery unit at TLV Medical Center is managed, as mentioned, by Dr. Galit Avinoam-Dar, a Mohs method specialist with extensive experience in removing cancerous skin lesions.

Do not weigh your options alone. Our doctors who specialize in Mohs method surgeries are among the experts in their field and will be happy to advise you personally on what is suitable, what you should do and when.

Doctors specializing in Mohs surgery

You should know that not all dermatologists or plastic surgeons are experts in the Mohs method.
A Mohs surgeon undergoes dermatopathology training and education, which is learning to read the histology. 
of skin cells, various tumors, their microscopic structure, and the ability to identify malignant or benign tumors.

תמונה של ד"ר אבינועם גלית

Avinoam-Dar Galit, MD

Specialty: Plastic surgery

תמונה של ד"ר רוית ינקו

Ravit Yanku, MD

Specialty: Plastic surgery

תמונה של ד"ר נמרוד פרבר

Nimrod Farber, MD

Specialty: Plastic surgery

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