Dr. Paul MacKoul, MD is a value-driven healthcare professional leader in the field of Gynecologic surgery, with an emphasis on developing surgical breakthroughs that generate “Value Based Care” – the most excellent 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 technologies” suited to freestanding surgery clinics. He is also the CEO of Tower Surgical Partners, a corporation focused on the expansion and growth of single-specialty GYN surgery clinics.
Processes, Methods, and Innovation
The development of new techniques and procedures to “alter the landscape” in any field of surgery entails 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 significant focus. GYN Oncology is the field’s highest level of surgical training, focusing on the surgical care of complex gynecological disorders and cancers. Since the OBGYN is primarily concerned with obstetrics rather than surgery, GYN Oncology training provides an excellent basis for surgery.
Dr. MacKoul obtained experience working with various seasoned GYN Oncologists after finishing his fellowship and finally became the Director, Gynecologic Oncology at Washington Hospital Center (WHC) in Washington, DC. WHC is a massive inner-city clinic that requires attention and devotion from many patients who lack insurance and have challenging medical and social issues. Dr. MacKoul worked particularly hard on the use of laparoscopic surgery, or minimally invasive surgery, to minimize huge open incisions. Patients with cancer and challenging surgical issues were able to leave the hospital the same day, recuperate faster, and begin treatment considerably sooner than if they had typical “open” surgery with far more significant pain and recovery time.
The next step in his professional advancement 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 treatment by reducing recovery time, discomfort, complications, and cost.
As surgical outcomes improved, Dr. MacKoul began to publish and share his findings on a national and international scale. The benefits of the methods created were recognized by various news outlets ranging from CNN, ABC, and KSN to Bloomberg News and HuffPost.
DualportGYN – An Innovative Approach to GYN Surgery
Dr. Paul MacKoul, MD and his collaborator Dr. Danilyants created, polished, and published DualportGYN, a specialized surgical procedure for the treatment of endometriosis, pelvic masses, and hysterectomy. In a comparison of 2600+ patients amongst robotics, laparoscopic, and vaginal techniques for hysterectomy, DualportGYN achieved the quickest recovery, fewest problems, and lowest cost of any other form of hysterectomy in the published literature. In fact, when compared to a similar robotic technique to hysterectomy, DualportGYN saved over $5,000. DualportGYN data was published in numerous major peer-reviewed journals, and the findings were presented at national conferences.
DualportGYN has also been demonstrated to be particularly effective at endometriosis eradication (or excision). DualportGYN employs a solid surgical technique known as “retroperitoneal dissection,” which enables the total removal of all illness while completely exposing and avoiding harm to surrounding structures and significantly reducing complications. Endometriosis patients now had a surgical option that was considerably better and less invasive than many 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 invented procedure, was even more groundbreaking than DualportGYN. LAAM fibroid removal procedure eliminates fibroids from the uterus while leaving the uterus fertile. LAAM did not necessitate a big open incision for fibroid removal, nor did it employ an expensive and time-consuming Robot for the treatment, which would have increased complications, incisions, and costs. 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 vs. robotics, open, and laparoscopic techniques, demonstrating the lowest complication rates and quickest recovery.
LAAM has convincingly demonstrated that it removes more fibroids from the uterus in all sites than laparoscopic and robotic surgery while retaining safety and effectiveness. LAAM has been presented at various conferences across the United States.
Dr. MacKoul’s two highly effective and powerful surgical techniques for hysterectomy, fibroid removal surgery, and endometriosis clearly demonstrated that the procedure could be done “outpatient,” meaning that the patients returned home the same day. The operations’ safety and effectiveness were proven, and it became evident that there was no reason why these procedures couldn’t be conducted outside of the hospital, in a freestanding surgery facility.
The Future of GYN Surgical Care: The Freestanding ASC
Patients and the healthcare system benefit significantly from freestanding surgery centers that specialize in GYN surgery. Because the surgical center’s “focus” is solely on GYN surgery, the quality of care and patient satisfaction is better. This improves care quality and reduces problems. Also, independent surgery centers are 60% less expensive than hospitals. This was a substantial cost saving that was compounded when comparing DualportGYN with LAAM Fibroids to robotic or other techniques.
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 new 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 scenario. The resulting “transition” from the hospital to the freestanding ASC improved results while drastically lowering surgery costs. Reducing costs allows patients, doctors, insurers, and the healthcare system as a whole to operate more efficiently and effectively.
Every GYN surgeon 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. Conducting 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.
Dr. Paul MacKoul, MD 