The Belgian Mohs Group

Mohs micrographic surgery is designed to remove skin tumours in areas where there is little area to take much margin.
The technique is named according to Dr Fredrick E. Mohs, who developed it.

Who are we?

The Belgian Mohs Group is a working group that unites Belgian dermatologists who perform Mohs micrographic surgery. These doctors have undergone additional training for this.

What are our goals?
- To familiarize Belgian doctors (dermatologists, general practitioners and other specialists) with Mohs micrographic surgery and its benefits.
- Share expertise and experience with Mohs micrographic surgery in Belgium with colleagues.
- To set up a full-fledged training course for Mohs micrographic surgery in Belgium.
- To obtain a correct reimbursement through the mutualities.

What is Mohs Surgery?

Mohs micrographic surgery is intended for the removal of skin tumors in areas where there is not enough space to take a wide margin. 100% of the outer edges are assessed using horizontal frozen sections or paraffin sections (Slow Mohs). The technique is named after doctor Fredrick E. Mohs who developed the technique.

Mohs micrographic surgery is performed according to a well-defined protocol. The lesion is cut out in a dish-shape. The specimen edges are stained. Immediately after excision, the entire outer edges of the removed tissue are fully examined under the microscope. If tumorcells are still observed somewhere in the edges, an additional resection can be done very specifically. As a result, the cutting margins are very small and the unnecessary removal of healthy tissue is prevented. This makes it
especially suitable for facial tumors. Due to the high degree of certainty of radicality, large defects can also be closed without the risk of reoperation.

The Mohs surgeon is skilled in closing the defects him/herself, but in some cases will collaborate with other specialists such as plastic surgeons, oculoplastic surgeons and ENT-doctors.

Differences from regular excision?

Mohs micrographic surgery is safer and faster than regular excision.

More certainty: with Mohs, 100% of the cut edges (side and bottom) are imaged. In a regular excision, vertical lamellae are taken from the specimen and examined under the microscope. As a result, a piece of tumor can be missed, in contrast to Mohs.

Quicker: with Mohs, the result is known within a few hours. However, with regular excisions with paraffin sections, it takes several days before the result of the microscopic examination is known.
Although regular excision with frozen sections allows quick judgment, not all cut edges are visualized.

For which skin cancers is Mohs micrographic surgery suitable?
The technique is particularly suitable for basalcellcarcinomas
- in the face;
- of an aggressive subtype;
- that have not been completely removed during previous treatment
- that have recurred after treatment.

It is also increasingly used for other skin tumours including:
- squamouscellcarcinomas
- dermatofibrosarcoma protuberans
- atypical fibroxanthomas

Benefits of Mohs surgery:
The greatest benefits of Mohs surgery are:

- That 100% of the edges are examined (unlike the conventional techniques where slices are randomly and examined). This is especially important for infiltrative skin tumors .
- The result of the frozen sections is known within hours instead of days.
- That dermatologists can work very precise and that as much healthy tissue is spared as possible.

Where can patients undergo Mohs micrographic surgery?:
Dept. Dermatology AZ Turnhout
Dept. Dermatology UZ Ghent
Dept. Dermatology UZ Leuven
Dept. Dermatology UZ Antwerp
Dept. Dermatology UZ Brussels
Dept. Dermatology ZOL Genk

Dept. Dermatology Sint-Dimpna Ziekenhuis Geel