About

Dr. Paul MacKoul, MD is a value-driven healthcare professional leader in the field of Gynecologic surgery, with a focus on developing surgical innovations that create "Value Based Care" - the best care at the lowest possible cost. Dr. MacKoul is currently the Co-founder of the Center for Innovative GYN Care, a practice leader in the development of "new procedural technology" applicable to free-standing surgery centers. He is also the CEO of Tower Surgical Partners, a company focused on the expansion and growth of single-specialty GYN surgery centers.

Procedures, Techniques, and Innovation

The development of new techniques and procedures to "change the landscape" in any field of surgery requires first being exposed to current methods of surgery, then adapting and changing the surgical approach to achieve a better outcome. Dr. MacKoul felt it was critical to complete a fellowship in Gynecological Oncology in order to learn how to perform surgery as a primary focus. GYN Oncology is the field's highest level of surgical training, focusing on the surgical management of complex gynecological problems and cancers. Given that the OBGYN is primarily concerned with obstetrics rather than surgery, GYN Oncology training provided an excellent foundation for surgery.

Dr. MacKoul gained experience working with several experienced GYN Oncologists after completing his fellowship and eventually became the Director, Gynecologic Oncology at Washington Hospital Center (WHC) in Washington, DC. WHC is a sizeable inner-city facility that requires dedication and devotion from many patients who lack insurance and face complex medical and social challenges. Dr. MacKoul worked particularly hard on the use of laparoscopic surgery, or minimally invasive surgery, to avoid large open incisions. Patients with cancer and complex surgical challenges were able to leave the hospital the same day, recover faster, and begin treatment much sooner than if they had traditional "open" surgery with much more pain and recovery time.

The next step in his professional development was to become Division Director, Gynecological Oncology, at the George Washington University Medical Center in downtown Washington, DC. 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 to residents, which improved women's care by reducing recovery time, pain, complications, and cost.

As surgical outcomes improved, Dr. MacKoul began to publish and discuss his findings on a national and international scale. The benefits of the procedures developed were recognized by major news outlets ranging from CNN, ABC, and KSN to Bloomberg News and HuffPost.

DualportGYN - An Innovative Approach to GYN Surgery

Dr. MacKoul and his partner Dr. Danilyants developed, perfected, and published DualportGYN, a specialized surgical technique for the treatment of endometriosis, pelvic masses, and hysterectomy. In a comparison of 2600+ patients between robotics, laparoscopic, and vaginal approaches for hysterectomy, DualportGYN achieved the quickest recovery, fewest complications, and lowest cost of any other form of hysterectomy in the published literature. In fact, when compared to a similar robotic approach to hysterectomy, DualportGYN saved over $5,000. DualportGYN data was published in multiple major peer-reviewed journals, and the findings were discussed at national conferences.

DualportGYN has also been shown to be very effective at endometriosis removal (or excision). DualportGYN employs a powerful surgical technique known as "retroperitoneal dissection," which allows for the complete removal of all disease while fully exposing and avoiding injury to surrounding structures and significantly reducing complications. Endometriosis patients now had a surgical option that was far better and less invasive than multiple robotic incisions, and it could be done much faster and at a much lower cost.

LAAM - A Uterine Sparing Fibroid Removal Revolution

LAAM Fibroid surgery, a second-developed procedure, was even more revolutionary than DualportGYN. LAAM fibroid removal surgery removed fibroids from the uterus while leaving the uterus fertile. LAAM did not necessitate a large open incision for fibroid removal, nor did it employ an expensive and time-consuming Robot for the procedure, which would have increased complications, incisions, and cost. Instead, LAAM required only two incisions to remove fibroids of any size throughout the uterus, with all patients returning home the same day. LAAM has been refined over thousands of cases and has been published in a comparison trial versus robotics, open, and laparoscopic approaches, demonstrating the lowest complication rates and quickest recovery.

LAAM has clearly demonstrated that it removes more fibroids from the uterus in all locations than laparoscopic and robotic surgery while maintaining safety and effectiveness. LAAM has been presented at major conferences across the United States.

Dr. MacKoul's two highly effective and powerful surgical approaches to hysterectomy, fibroid removal surgery, and endometriosis, clearly demonstrated that the surgery could be done "outpatient," meaning that the patients went home the same day. The procedures' safety and effectiveness were confirmed, and it became clear that there was no reason why these procedures couldn't be performed outside of the hospital, in a free-standing surgery center.

The Future of GYN Surgical Care: The Free-Standing ASC

Patients and the healthcare system benefit significantly from free-standing surgery centers that specialize in GYN surgery. Because the surgery center's "focus" is solely on GYN surgery, the quality of care and patient satisfaction is higher. This improves care quality and reduces complications. Furthermore, independent surgery centers are 60% less expensive than hospitals. This was a substantial cost saving that was compounded when comparing DualportGYN and LAAM Fibroids to robotic or other approaches.

Dr. MacKoul established the first ambulatory surgery center, or ASC, in Rockville, MD, through Tower Surgical Partners. A second location opened in Maryland, and a third in Secaucus, New Jersey. These ASCs are "state of the art," with the best equipment and optics, and the highest safety profile possible, thanks to specially trained staff, "cell savers" that avoid transfusion, the lowest infection rates, and an environment that is very conducive to the highest quality of GYN surgery available.

GYN Surgery Must Aim for Value-Based Care

Dr. MacKoul's career has been centered on Value-Based Care. The advancement of powerful and innovative techniques and procedures, such as DualportGYN and LAAM Fibroid surgery, enables lower complications, better outcomes, and lower costs. The outcomes' safety and effectiveness bolstered the performance of both DualportGYN and LAAM Fibroids in the non-hospital ASC setting. The resulting "shift" from the hospital to the free-standing ASC improved outcomes while dramatically lowering surgery costs. Reducing costs allows patients, doctors, insurers, and the healthcare system as a whole to operate more efficiently and effectively.

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 best possible care at the lowest possible cost. Performing these procedures at freestanding surgery centers helps to achieve that goal, and it is Dr. MacKoul's mission to provide surgical training for doctors as well as patient access to ASCs to further the development of this Value-Based Care approach to GYN surgery.