Von der „mikroskopisch kontrollierten Chirurgie” zur „3D-Histologie” – eine Erfolgsgeschichte

„Microscopically controlled surgery” emerged by the histopathologic interest of surgeons more than 150 years ago. The very important initiator of microscopically controlled surgery of skin tumours was Frederic Edward Mohs (1919 - 2002), an American surgeon in the middle of the 19th century. Mohs introduced the in situ fixation of tumours, followed by the surgical excision and histopathological examination of the surgical specimen. Later the chemical in situ fixation was replaced by modern histopathological techniques. „Mohs surgery” became rather a histopathological method. Various surgeons have developed a multitude of technical variations with various denominations. The common principle comprises a) topographic orientation and b) excision of a tumour, c) three-dimensional visualization of the lateral margins and the base of the specimen by frozen or paraffin sections, d) histopathological evaluation, if subclinical tumour strands persist and, if necessary e) additional stages of surgery until tumour-free margins are obtained. Continous visualization of three-dimensional excision margins is the concept used in various tumour entities. „Microscopically controlled surgery” is not a surgical technique but rather a three-dimensional histopathological procedure. The denomination „3D-histology” is generic, universal, and understandable even on an interdisciplinary basis.