Advancing Surgical Efficiency: Lessons from Dr. Ganesan’s Experience at Muljibhai Patel Urological Hospital
Vishnu Ganesan, MD, was selected to participate in the AUA/USI Academic Exchange Program this past January. This prestigious program offers early-career academic urologists the opportunity to share knowledge, build professional relationships, and learn from colleagues in India.
For Dr. Ganesan, the most impactful part of the experience was visiting the Muljibhai Patel Urological Hospital (MPUH) in Nadiad. “It is a remarkable Center of Excellence where they focus exclusively on urologic care,” he explained. “Despite being located in a smaller town, the volume of cases they do is staggering. They easily perform three to four times the number of cases we do across the entire M Health Fairview system. Seeing a single hospital manage that level of patient flow with such high-quality outcomes was truly unforgettable.”
What struck Dr. Ganesan most was how the hospital schedules its surgeries. Unlike the United States where surgeries are scheduled weeks or even months in advance, MPUH builds its daily schedule based on the patients who arrive in the clinic the day before. “If a patient arrives with an acute stone, they are often admitted and operated on the very next day,” he said. “They work hard, six days a week, including Saturdays.”
He was also struck by the team’s emphasis on cost-effectiveness and resourcefulness. “The resourcefulness at MPUH is born out of necessity. Since many patients pay out-of-pocket, the surgical teams try to minimize waste. They sterilize and reuse equipment and minimize use of disposables.” Inspired by this approach, Dr. Ganesan hopes to bring similar efficiencies to the University of Minnesota Department of Urology’s stone program. “Seeing how they prioritize acute cases to save patients from multiple trips and long wait times is something I want to emulate. I’m also looking at ways to reduce surgical waste and minimize the use of extra disposables in my own OR to help decrease costs for our system and patients.”
Another memorable aspect of the trip was MPUH’s cafeteria system. “You send a quick text message, and a full lunch platter is delivered to the physician lounge. For about one dollar, you get an amazing spread of local food,” he said. “It was just incredible. You send a text, and ten minutes later you're eating world-class food for a dollar while prepping for the next case.”
Working alongside Dr. Abhishek Singh and Dr. Ravindra Sabnis was also a highlight. “I spent time in the clinic and observed their techniques for ureteroscopy and PCNL—percutaneous nephrolithotomy—cases,” he shared. “While our equipment is similar, the sheer speed and efficiency of their team provided several ‘tricks of the trade’ that I’ve already started incorporating into my own practice. There was a great sense of camaraderie in discussing these cases and sharing different perspectives on surgical technique.”
Dr. Ganesan also had the honor of presenting his work at the Urological Society of India Annual Conference (USICON), where he connected with international colleagues. While at the conference, he reunited with former Department of Urology faculty member and recent visiting professor Dr. Aseem Shukla of the Children’s Hospital of Philadelphia (CHOP). “He was there on a medical mission. It was invaluable to spend time with him observing complex pediatric urology cases and learning how he established such a successful program,” said Dr. Ganesan.
The AUA/USI Exchange Program program may be over, but Dr. Ganesan is still processing and already changing how he works because of it.
