Dr Mangal Parihar (Mumbai India)- Mangal Anand Hospital

Doctor information and response from Mangal Anand Center for Limb Lengthening & Reconstruction, located in Mumbai, India. Contact them for specific information and latest updates.
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Background, Training and Qualifications:

Profile
Dr. Mangal Parihar is an Orthopedic Surgeon, whose area of specialization includes Deformity Correction, Limb Lengthening using Ilizarov techniques and Orthofix fixators and Joint Replacement.

Dr. Parihar’s reputation and expertise extends equally to children and adults in the diagnosis and treatment of special orthopedic conditions including congenital limb deformities, post-traumatic limb conditions, bone healing problems, bone defects, skeletal dysplasias, metabolic disorders, foot deformities, peripheral nerve disorders, and other miscellaneous developmental deformities. For the past many years, Dr. Parihar has dedicated his career to improving the lives of patients with limb disorders.

He has performed numerous limb reconstruction surgeries using some of the most advanced surgical methods used for lengthening and deformity correction. He is the leading reconstruction orthopedic surgeon in the country and holds an acclaimed presence amongst his peers. He regularly receives referrals from across the country and overseas, for problems that have not resolved with conventional orthopedic surgery. He is constantly updating himself with the latest techniques to bring the best to the patient. Recently, he has been instrumental in bringing Hexapod — the six-axis correction system to India, which has revolutionized the world of deformity correction and limb reconstruction.

Dr. Parihar's expertise includes performing the whole gamut of orthopedic surgeries; be it soft tissue surgeries, or internal or external fixation for fractures, or internal or external fixation for deformity correction and limb reconstruction, or combined internal and external fixation for limb lengthening and reconstruction, or joint reconstruction using external fixation or joint replacement.

The surgeries are performed using state-of-the art equipment and techniques, with the utmost care for the soft tissue using minimally invasive techniques especially minimally invasive osteotomies. Dr. Parihar has popularized the Fixator Assisted HTO — a minimally invasive technique for precise correction of alignment in osteoarthritis of the knee, and intra-articular osteotomy for treatment of malunited proximal tibial fractures.

Qualifications:
Undergraduate and Postgraduate training at Seth G S. Medical College and KEM Hospital, Bombay
MBBS: University of Bombay (1984)
MS (Orth): University of Bombay (1988)

Hon. Orthopedic Surgeon
- Sir. H.N. Hospital
- Fortis Hospital
- Police Hospital, Nagpada

Academic Honors:
First in the University at the Final MBBS exam of June 1984
MS (Orth) at first attempt in July 1988

Fellowship and Specialized Training:
Visiting Orthopedic Fellow, Total Joint Arthroplasty
with Dr. C. S. Ranawat; at Hospital for Special Surgery (sponsored by the Ranawat Orthopedic Research Foundation), New York, USA (10/15/93 - 1/15/94)

Post-Doctoral Fellow, Ilizarov Techniques
with Dr. Dror Paley at the Maryland Center for Limb Lengthening and Reconstruction, Baltimore, USA (1/8/92 - 2/28/93)

Registrar, Orthopedics
Blackburn Royal Infirmary, Blackburn, England (1/8/91 - 7/31/92)

Clinical Training:
Registrar, Orthopedics
Seth G. S. Medical College and K. E. M. Hospital, Bombay (1/8/87 - 7/31/89)

House Surgeon, Orthopedics
Seth G. S. Medical College and K.E.M. Hospital, Bombay (1/8/85 - 7/31/87)

Rotating Internship
in Medicine, Surgery, Gynae and Obstetrics, Seth G. S. Medical College and KEM Hospital, Bombay (6/25/84 - 6/24/85)

Academic Staff Appointments:
Lecturer, Orthopedics; Seth G S. Medical College and KEM Hospital, Bombay (11/24/89 - 3/15/91)

Hon. Assistant Professor, Orthopedic Surgery, Sir J.J. Group of Hospitals & Grant Medical College

Examiner, Orthopedic section Third MBBS Examination, University of Bombay

Professional Memberships
Vice President (2014), ASAMI (Association for Study & Applications of the Methods of Ilizarov), India.

Executive committee member, BOS (Bombay Orthopedic Society) 1998 - 2001

Life Member, Indian Orthopedic Association (IOA), Pediatric Orthopedic Society of India (POSI), & Bombay Orthopedic Society (BOS)

____________________

Here's the response from Dr Mangal Parihar about  Limb Lengthening surgery

1) How many patients have you operated for cosmetic Limb Lengthening so far and How many patients do you operate yearly?

10 up to now. about 1 or 2 a year.

2) What is the estimated total cost, including post-op treatments, stay, medications, physiotherapy? Are unscheduled surgeries covered and How much does a consultation cost?

The overall costs for the procedure come to around Indian Rupees 9,00,000/-(Rupees nine hundred thousand). This includes the hospital stay, professional fees while in the hospital, the cost of the ring fixators and the nails. The stay after discharge has to be in a hotel (rates can vary from Rs3000-7000/- per day).

3) What kind of physical therapy is assigned to the patient?

All patients have been local, they usually continue with physio at their residence. For non locals, you could have a therapist visit you.

4) What maximum amount of lengthening do you recommend per segment, regarding patient safety? What is the daily rate of lengthening?

Max 6 cms. daily rate 0.75 to 1 mm, depending on pain and muscle tightness.

5)  What are your opinions regarding the weightbearing of the patients?

i am not a big fan of walking while the distraction is going on. patients are allowed bed to chair transfers, bed to toilet, and standing while distracting. i don't encourage walking. after the nails are locked, in the early period they are not strong enough to take full weight, so again about 4 weeks of protected weight bearing, and increase weight bearing as the X-rays show progress in healing.


6)  How often will you follow up with patients during lengthening?

patients stay in mumbai during the distraction phase, and i see them in clinic every 2 weeks. if any problems, i see them at shorter intervals.


7) How fast can patients return to normal life (walking without support)?  What is the time required to lengthen 5 cm and 7.5-8 cm ?
in my experience, none of the patients have been walking without support before 6 months. (thought they may get onto a single stick by 4 months or so)

Dr Mangal Parihar
Orthopedic Surgeon
Tel: +91-22-2522 4845 / 022-2526 0000.
Fax: +91-22-2523 5416
Email: [email protected]
Website: http://www.ilizarov.in

Great post.

US dollar = 61.30 Rupees

Euro = 83.04 Rupees

900,000 Rupees / 61.30 = $14861

900,000 /83.04 = 10838 Euros

Price seems reasonable. He only takes 2 people per year? 

Ah, good to see Dr. Parihar on the list. He's one of the Indian docs I think people can be sure isn't a quack. He's trained under Dr. Paley.

One thing to remember is that due to lack of accommodation, if you are there for 5 months you may spend an additional $7,500 - $15,000 just on a hotel. So the cost will be between $20,000 - $30,000, not including all the other stuff you may need.

Too bad we cant get any patient testimonials for him.

If one did go , cant they rent a flat for a lot less than a hotel? 

To rent a flat is easy and almost free if you compare to a hotel. Physios are cheap too.

Hotel is expensive if you stay for months (applies anywhere in the world). But if you rent a room or apartment in india, it'll be much cheaper. 

Quote from: Sweden on October 11, 2013, 01:22:41 AMTo rent a flat is easy and almost free if you compare to a hotel. Physios are cheap too.

From what my friend in India tells me, it's much more difficult to rent a flat or apartment in India than in other places if you don't have a local to vouch for you, so most foreigners opt for staying in hotels. My old professor is from India as well and she told me the same thing when I expressed interest in staying in India. Apparently, many Indian landlords have certain rules you're expected to follow unless you want to get evicted, such as no alcohol, no eating meat, no staying out past a certain hour, no males and females staying together, etc. Many won't rent to foreigners, period. If someone were to decide to go to Dr. Parihar, it's best to have someone in Mumbai you can stay with, or see if the doctor can help arrange something or connect you with someone willing to rent.

He doesn't seem to be persuasive about gaining patients which is a good thing.

But however, he doesn't provide any physiotherapy options himself. He doesn't seem to stress the need of physiotherapy.
You "could" have a therapist visit you?

Quote from: short_and_depressed on October 11, 2013, 12:12:35 PMHe doesn't seem to be persuasive about gaining patients which is a good thing.

But however, he doesn't provide any physiotherapy options himself. He doesn't seem to stress the need of physiotherapy.
You "could" have a therapist visit you?

He does realize the importance of physiotherapy.

"Much is spoken about physiotherapy and it's importance in the Ilizarov method. Unfortunately, this is infrequently translated into practice. One just has to look at many cases with iatrogenic problems to realize that lack of physiotherapy lies at the root of the majority of these. The patient has to participate in a proper program of exercises, mobilization and ambulation. This cannot be stressed enough. Lack of proper physiotherapy can turn even the technically excellent surgery into a poor result, and nowhere is this more true than in the subspecialty of Ilizarov surgery. In fact Ilizarov's original technique requires the patients to stay in hospital and participate in at least two hours of therapy in various forms every day. In our circumstances, the services of a physiotherapist are not always available. The only recourse in such cases is for the surgeon himself to supervise the therapy for the patient. Achieving length or correcting a deformity at the cost of decreased motion, mobility or function is certainly not a worthwhile goal."

http://www.limblengtheningforum.com/index.php?topic=22.0

Yeah, but his reply to Daemon doesn't indicate the importance of PT.