Dr. Paul MacKoul, MD

Dr. Paul MacKoul, MD, is a value-driven leader in the field of gynecologic surgery, with a focus on developing innovations in surgery that create "Value-Based Care" - the highest quality care at the lowest cost. Dr. MacKoul is currently the co-founder of the Center for Innovative GYN Care, a leader in the development of "new procedural technology" applicable to freestanding surgery centers. He is also the CEO of Tower Surgical Partners, a company that specializes in the expansion and growth of GYN surgery centers with a single specialty.

The development of new techniques and procedures to "change the landscape" in any field of surgery requires exposure to current surgical practices, followed by adaptation and modification to achieve a better outcome. The completion of a fellowship in gynecological oncology was essential for Dr. MacKoul to learn how to perform surgery as his primary focus. The highest level of surgical training available in the field, GYN Oncology, focuses on the surgical management of complex gynecological problems and cancers. GYN Oncology training provided an excellent foundation for surgery in recognition of the fact that OBGYNs focus primarily on obstetrics and not surgery.

After completing his fellowship, Dr. MacKoul gained experience working with a number of seasoned GYN Oncologists before becoming the Director of Gynecologic Oncology at Washington Hospital Center (WHC) in Washington, D.C. WHC is a massive inner-city facility that required dedication in the Care and devotion of many uninsured patients with very challenging medical and social issues. The use of laparoscopic or minimally invasive surgery to avoid large open incisions was one of Dr. MacKoul's primary areas of focus. The incorporation of new techniques into the surgery allowed patients with cancer and complex surgical challenges to leave the hospital on the same day, recover more quickly, and begin treatment much sooner than if they had undergone traditional "open" surgery, which is significantly more painful and requires a more extended period of recovery.

The next step in his career was to become Division Director of Gynecological Oncology at the George Washington University Medical Center in downtown Washington, D.C. At the time, Dr. MacKoul was the Director of Minimally Invasive GYN Surgery at Holy Cross Hospital in Silver Spring, Maryland, a GW Medical Center affiliate. Dr. MacKoul was able to teach new techniques and procedures that significantly decreased recovery time, pain, complications, and cost by instructing residents.

As surgical outcomes improved, Dr. Paul MacKoul, MD began publishing and discussing his findings on a national and international scale. CNN, ABC, and KSN, as well as major news outlets such as Bloomberg News and Huffington, acknowledged the benefits of the developed procedures.
DualportGYN, a specialized surgical technique for the treatment of endometriosis, pelvic masses, and hysterectomy, was created by Dr. MacKoul and Dr. Danilyants, who then published it. Specifically for hysterectomy, in a comparison of over 2600 patients between robotics, laparoscopic, and vaginal approaches, DualportGYN achieved the quickest recovery, lowest complications, and lowest cost of any other method. In fact, DualportGYN saved over $5,000 when compared to a similar robotic hysterectomy technique. Multiple major peer-reviewed journals published DualportGYN data, and the results were discussed at national conferences.

DualportGYN was also demonstrated to be highly effective at endometriosis excision. DualportGYN employs a powerful surgical technique known as "retroperitoneal dissection" that enables the complete removal of all disease while exposing all surrounding structures and avoiding damage to them, thereby drastically reducing complications. Endometriosis patients now had access to a surgical option that was vastly superior and less invasive than multiple incisions with robotics and that could be performed much more quickly and at a lower cost.

The LAAM Fibroid surgery, a second-developed procedure, was even more revolutionary than DualportGYN. The LAAM fibroid removal procedure removed fibroids from the uterus, preserving fertility. LAAM did not require a large open incision for fibroid removal and did not use a costly and time-consuming Robot for the procedure, which would have increased complications, incisions, and costs. In contrast, LAAM required only two incisions to remove fibroids of any size from the uterus, and all patients returned home the same day. LAAM was perfected over thousands of cases, and a study comparing it to robotics, open, and laparoscopic techniques revealed that it has the lowest complication rates and fastest recovery time.

LAAM has been demonstrated to remove more fibroids from the uterus in all locations than laparoscopic and robotic surgery while maintaining safety and efficacy. LAAM has been presented at significant conferences across the United States.

These two highly effective and potent surgical approaches to hysterectomy, fibroid removal surgery, and endometriosis developed by Dr. MacKoul clearly demonstrated that the surgery could be performed on an "outpatient" basis, meaning that the patients were able to return home the same day as the procedure. After confirming the safety and efficacy of the systems, it became evident that there was no reason why they could not be performed in an independent surgery center outside of the hospital.

Freestanding surgery centers that specialize in gynecologic surgery offer numerous advantages to patients and the healthcare system. As a result of the surgery center's exclusive "concentration" on gynecologic surgery, patient Care and satisfaction are of a higher standard. This enhances the standard of Care and reduces complications. However, independent surgery centers are 60% less expensive than hospitals. Comparing DualportGYN and LAAM Fibroids to mechanical or other methods, this was a significant cost saving that added to the overall cost savings.

Via Tower Surgical Partners, Dr. MacKoul opened Rockville, Maryland's first ambulatory surgery center (ASC). The second location opened in Maryland, and the third in Secaucus, New Jersey. These ASCs are "state of the art" with the best equipment and optics and the highest safety profile possible with specially trained staff, "cell savers" that eliminate the need for blood transfusions, the lowest infection rates, and an environment that is conducive to the highest quality GYN surgery available.

Value-Based Care has been the focal point of Dr. MacKoul's career. The development of effective and new techniques and procedures, such as DualportGYN and LAAM Fibroid surgery, allows for decreased complications, improved outcomes, and decreased costs. The safety and efficacy of the results supported the performance of DualportGYN and LAAM Fibroids in the ASC setting outside of the hospital. The resulting "transition" from the hospital to the freestanding ASC further improved surgical outcomes and drastically reduced expenses. Patients, physicians, insurers, and the healthcare system as a whole perform more efficiently and effectively when costs are reduced.

All GYN surgeons should strive to learn and develop techniques as influential as DualportGYN and LAAM Fibroids in order to provide their patients with the highest quality care at the lowest possible cost. Conducting these procedures at freestanding surgery centers advances this objective, and Dr. MacKoul's mission is to provide surgical training for doctors and access to ASCs for patients in order to further the growth of this Value-Based Care approach to GYN surgery.