Name of the Procedure:

Excision of malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less Common name(s): Skin cancer removal surgery

Summary

This surgery involves removing a small area of skin that contains cancer or is suspected to contain cancer, along with a small margin of healthy tissue around it. The procedure is typically done on the trunk, arms, or legs and is performed on lesions of 0.5 cm or less in diameter.

Purpose

The main purpose of this procedure is to completely remove cancerous lesions from the skin to prevent the spread or growth of skin cancer. By excising the lesion and some surrounding tissue, the goal is to ensure no malignant cells are left behind, reducing the risk of recurrence.

Indications

• Presence of a confirmed or suspected malignant skin lesion.
• Lesion located on the trunk, arms, or legs.
• Lesion size of 0.5 cm or smaller in diameter.
• Biopsy results indicating malignancy in a skin lesion.

Preparation

• Patients may need to fast for a few hours prior to the procedure if sedation is planned.
• Medications such as blood thinners might need to be paused under medical supervision.
• A pre-procedure assessment, including a physical examination and possibly blood tests, will be conducted.
• Local anesthesia will typically be administered.

Procedure Description

1. The area around the lesion is cleaned and sterilized.
2. Local anesthesia is injected to numb the area.
3. The surgeon uses a scalpel to excise the lesion along with a small margin of healthy tissue.
4. The excised tissue is sent for pathological evaluation to ensure complete removal of cancerous cells.
5. The wound is then sutured closed and dressed with a sterile bandage.
6. The patient will be monitored for any immediate postoperative issues.

Duration

The procedure typically takes about 20 to 30 minutes.

Setting

The procedure can be performed in a hospital outpatient clinic or a surgical center.

Personnel

• Surgeon
• Surgical nurse
• Anesthesiologist or nurse anesthetist (if sedation is used)

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Scarring or changes in skin texture
• Possible need for further surgery if margins are not clear
• Rarely, reactions to anesthesia

Benefits

• Complete removal of the malignant lesion, which reduces the risk of cancer spreading.
• Rapid pathology results to confirm clear margins.
• Minimal injury to surrounding healthy tissue, preserving function and appearance.

Recovery

• Patients are usually able to go home the same day.
• Keep the surgical site clean and dry.
• Follow-up appointments for wound inspection and suture removal, typically within 1-2 weeks.
• Avoid strenuous activities until the wound has sufficiently healed.
• Full recovery can be expected in 1-2 weeks, depending on individual healing rates.

Alternatives

• Mohs surgery: More precise technique but may be more expensive.
• Cryosurgery: Freezing off the lesion, less invasive but may not be suitable for all types of lesions.
• Radiation therapy: Non-surgical option, but usually reserved for larger or harder-to-reach lesions.
• Topical medications: Used for very small or superficial lesions, but less reliable for complete removal.

Patient Experience

During the procedure, the patient will be awake but should not feel pain due to local anesthesia. Some pressure or tugging sensations might be noticeable. Postoperatively, mild discomfort and tenderness at the surgical site are common, which can be managed with over-the-counter pain medications. Most patients experience minimal scarring, and any sutures will typically be removed in a follow-up visit.