My Mohs Surgery for Basal Cell Cancer
Location: Dermatology & Skin Cancer Center
11550 Gernada, Leawood, Ks.
Operation: Mohs Micrographic Surgery
Diagnosis: Basal cell Carcinoma
Surgeons: Glenn D. Goldstein, MD
Jamie L McGinness, MD
Anestesia: Local, 1% Lidocaine with Epinephrine 1:100,000 and Bicarbonate
Mohs Micrographic Surgery
- The lesion was aggressively debulked with a scalpel and dermal curette.
- A layer of tumor-containing tissue with a thin margin of normal-appearing tissue was excised.
- Hemostasis was achieved with spot electrocoagulation.
- The resected tissue was oriented relative to the surgical defect and a map of the defect was drawn.
- A pressure dressing consisting of Telfa, gauze and paper tape was affixed to the defect.
- The resected tissue was divided into appropriately sized specimens while maintaining orientation relative to the map
- The specimens were marked with tissue dyes with corresponding markings on map.
- The specimens were processed by horizontal frozen sections that allowed the examination of the entire superficial peripheral as well as deep margins.
- The frozen section specimens were stained with hematoxylin and eosin, and systematically examined by the surgeon for the presence of tumor.
If tumor cells were found in any margin, a notation in red was made on the map and the patient was returned to the operating room for additional surgery directed only to the areas still involved by tumor. The preparation and steps 2-9 were repeated until no more tumor cells were identified in any of the horizontal frozen sections.
- Stage 1 included multiple microscopic sections of 4 tissue specimens.
- Stage 2 included multiple microscopic sections of 1 tissue specimens
At this point, no further tumor cells were identified and the tumor eradication was considered to be complete after a total of 2 stages of surgery in which multiple microscopic sections of 5 tissues were examined.
"Dr. Glenn Goldstein is the Director of the Dermatology and Skin Cancer Center in Leawood, Kansas. Dr. Goldstein has been in practice in Kansas City for over 20 years. His training in internal medicine and dermatology was at the University of Kansas Medical Center. He subsequently completed his Mohs and Dermatologic Surgery Fellowship at the University of Iowa Hospitals and Clinics."
My take: I like Dr Goldstien, I'd give him four thumbs up. Mine and yours. He makes you feel comfortable as a patient and seems to be very through in his assessment. He's always listened and answered my questions, which I usually have several. As a Mohs surgeon, he was all business, and explained everything as he was performing the surgery.