Dr. Paul MacKoul MD is a highly-respected healthcare professional leader in Gynecologic surgery who is focused on developing innovations in surgery that create “Value Based Care” - the best possible care at the lowest possible cost. He 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.

1. 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.

2. 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 – A Exceptional Approach 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.

3. 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.

4. 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 Standing ASC – 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

5. 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.