Paul MacKoul Individual Bio

Dr. Paul MacKoul MD is a value-driven healthcare professional leader in Gynecologic surgery, focusing on developing innovations in surgery that create “Value Based Care” - the best possible care at the lowest possible cost. Dr MacKoul is the Co-founder of the Center for Innovative GYN Care, a practice leader in creating “ new procedural technology” specifically applicable to free-standing surgery centers. He is also the Chief Executive Officer of Tower Surgical Partners, a company that expands and grows single-specialty GYN surgery centers.

Innovation,Techniques, and Procedures

Developing new techniques and procedures to "change the landscape" in any field of surgery first requires exposure to current ways surgery is being performed, then adapting and changing the surgical approach to create a better outcome. For Dr MacKoul, completing a fellowship in Gynecological Oncology was important to learn how to perform surgery as a primary focus. GYN Oncology is the highest level of surgical training possible in the field and focuses on managing complex gynecological problems and cancers. Understanding that the OBGYN concentrates mainly on Obstetrics, not surgery, GYN Oncology training provided an excellent foundation for surgery

After completing his fellowship, Dr MacKoul gained exposure working with several experienced GYN Oncologists and eventually became the Director, Gynecologic Oncology at Washington Hospital Center (WHC) in Washington, DC. WHC is a very large inner city-based facility that requires dedication in the care and devotion to many patients without insurance and had very difficult medical and social challenges. The use of laparoscopic surgery, or minimally invasive surgery, to avoid large open incisions was one of the areas Dr. MacKoul worked especially hard at. Incorporating new techniques in the surgery allowed patients with cancer and difficult surgical challenges to leave the hospital the same day, recover faster, and start treatment much sooner than if they had traditional "open" surgery with much more pain and recovery time.

Division Director, Gynecological Oncology at the George Washington University Medical Center in downtown Washington, DC, was his next professional development phase. At the time, Dr. Paul MacKoul MD was the Director of Minimally Invasive GYN Surgery at Holy Cross Hospital in Silver Spring, Maryland, an affiliate of the GW Medical Center Training residents allowed Dr MacKoul to teach new techniques and procedures that improved care for women, greatly decreasing recovery time, pain, complications, and cost.

With improvements in surgical outcomes, Dr MacKoul began to publish and discuss his results nationally and internationally. CNN, ABC, and KSN recognized the procedures' advantages to major news outlets such as Bloomberg News and HuffPost.

DualportGYN –AExceptionalApproach to GYN Surgery

DualportGYN, a specialized surgical technique for treating endometriosis, pelvic masses, and hysterectomy, was developed, perfected over thousands of cases, and then published by Dr. MacKoul and his partner Dr. Danilyants. Specifically for hysterectomy, in comparing 2600+ patients between robotics, laparoscopic and vaginal approaches, DualportGYN realized the fastest recovery, lowest complications, and lowest cost of any other form of hysterectomy in the published literature.

DualportGYN saved over $5,000 compared to a similar robotic approach to a hysterectomy DualportGYN data was published in multiple major peer-reviewed journals, and the results were discussed at conferences nationally.

DualportGYN was also shown to be very effective at removing – or excision – endometriosis. DualportGYN uses a powerful approach in a surgery known as “retroperitoneal dissection,” which allows for the complete removal of all disease while fully exposing and avoiding injury to surrounding structures and dramatically decreasing complications. Endometriosis patients now had a surgical option that was far better and less invasive than multiple incisions with robotics and could be performed faster and at much less cost.

LAAM – A Revolution in Uterine Sparing Fibroid Removal

According to Dr. Paul Mackoul MD A second developed procedure, the LAAM Fibroid surgery, was even more revolutionary than DualportGYN. LAAM fibroid removal surgery removed fibroids from the uterus, preserving the uterus for fertility LAAM did not require a large open incision for fibroid removal and did not use an expensive and tedious Robot for the procedure that increased complications, incisions, and cost. Instead, LAAM used only two incisions and could remove fibroids of any size throughout the uterus, with all patients going home the same day of the procedure. LAAM was perfected over thousands of cases and published in a comparison trial versus robotics, open, and laparoscopic approaches showing the lowest complication rates and fastest recovery.

LAAM has been proven to remove more fibroids from the uterus at all locations compared to laparoscopic and robotic surgery while maintaining safety and effectiveness. LAAM has been presented at major conferences throughout the US.

These two highly effective and powerful surgical approaches to hysterectomy, fibroid removal surgery, and endometriosis, as developed by Dr. MacKoul, clearly showed that the surgery could be done on an “outpatient” basis, meaning that the patients went home the day of the surgery. The safety and effectiveness of the procedures were confirmed, and it became clear that there was no reason why these procedures could not be performed in a free-standing surgery center and away from the hospital.

The Free StandingASC – the Future of GYN Surgical Care

Dr. Paul Mackoul MD mentioned that free-standing surgery centers focusing on GYN surgery only benefit patients and the healthcare system. The quality of care and patient satisfaction is higher simply because the “focus” of the surgery center is only on GYN surgery This increases the quality of care and decreases complications. Further, free-standing surgery centers are 60% cheaper than hospitals. These significant cost savings added to the savings when comparing DualportGYN and LAAM Fibroids to robotic or other approaches.

Through Tower Surgical Partners, Dr. MacKoul opened the first ambulatory surgery center, or ASC, in Rockville, MD A second is opened in Maryland, and a third is in Secaucus, NJ. 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 avoid transfusion, the lowest infection rates, and an atmosphere that is very amenable to the highest quality of GYN surgery available.

Value-Based Care – a Necessary Goal for GYN Surgery

Value-Based Care has been the focus of Dr Paul MacKoul MD, throughout his career Developing powerful and innovative techniques and procedures such as DualportGYN and LAAM Fibroid surgery

allows for lower complications, outcomes, and costs. The safety and effectiveness of the outcomes supported the performance of both DualportGYN and LAAM Fibroids in the non-hospital ASC setting. The resultant “shift” from the hospital to the free-standing ASC enhanced outcomes and dramatically lowered surgery costs. Lower costs help patients, physicians, insurers, and the healthcare system function more efficiently and effectively

It should be the goal of all GYN surgeons to learn and develop techniques as effective as DualportGYN and LAAM Fibroids to ensure their patients have access to the best possible care at the lowest possible cost. Performing these procedures at free standing surgery centers furthers that goal, and it is Dr. MacKoul’s mission to provide the surgical training for doctors, and access to ASC’s for patients to further the development of this Value Based Care approach to GYN surgery.