Doctor information about Dr Yasser Elbatrawy of Cairo International Centre for Limb Lengthening and Reconstruction (CICLLR), located in Cairo, Egypt. Contact him for specific information and latest updates.
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http://www.limblengtheningforum.com/index.php?topic=55.0Profile (From Website):One of the most prominent orthopedic surgeons worldwide. Dr. Yasser Elbatrawy is famous for limb lengthening and reconstruction (LLR). His Cairo International Centre for Limb Lengthening and Reconstruction (CICLLR) is the destination of patients from all over the world, especially USA, England, Canada, Australia, Germany, Spain and Japan.
CICLLR, not just an outpatient clinic but it arranges patients' accommodation and care during their stay in Cairo after lengthening procedure and help patients from day one of arrival to Cairo Airport. It is a policy of CICLLR to maintain the privacy of patients in general, as individuals of royal families of foreign countries and some nationally and internationally renowned movie stars have been treated. Arranging for a surgery is just a click away of your fingers, where necessary pre-/post-operative steps are taken upon directly contacting Dr. Elbatrawy.
Thanks to the great renown achieved by Dr. Elbatrawy in short stature lengthening, LLR and Ilizarov surgeries, one of the greatest private hospitals in Switzerland, has contracted with him as a visiting professor on a monthly basis to examine cases and operate on patients.
Dr. Elbatrawy has worked with the most famous specialists in limb lengthening for many years: 3 years with Dr. Maurizio Catagni (worldwide leading Ilizarov surgeon and founder of the Association for the Study and Application of the Methods of Ilizarov – ASAMI) in which he has earned ASAMI fellowship; 2 years with Dr. Dror Paley, Dr. John Herzenberg and Dr. Kevin Tetsworth, University of Maryland, Baltimore, MD, USA, in which he studied for his doctoral degree in limb lengthening and reconstruction surgeries and the University of Maryland fellowship in paediatric LLR and bone deformity correction; and 4 months in Ilizarov Institute, Kurgan, Siberia, in 2000 where he earned the advanced diploma of Ilizarov surgeries.
The Limb Lengthening and Reconstruction Centre, Baltimore, Maryland invites Dr. Elbatrawy on an annual basis to participate in instruction in the Annual International Course for Limb Lengthening and Bone Deformity Correction held in September yearly.
Since Dr. Elbatrawy specialized in limb lengthening and bone deformity correction in 1996, and his presentation of many research papers in specialized international conferences, he has been receiving invitations to participate in instruction in specialized courses in different countries. He also conducts demonstrational surgeries to train surgeons in such countries on LLR using special computer software and on applying Taylor Spatial Frame (TSF) to obtain the most precise results.
Dr. Elbatrawy has been chosen as Secretary-General for the second International Congress on External Fixation scheduled for October 2007 in Cairo (
www.externalfixation2007.com) with more than 600 specialists from all over the world shared in. Dr. Batrawy has been honored in many international conferences: he earned a prize for the best research work on LLR from organizations such as SICOT (Paris, France, 2001) and European Conference on Trauma Surgery (Eurotrauma) (Gratz, Austria, 2007). Nationally, he has been honored by Al-Azhar University where he has attended the University Council and has been handed the University Shield in recognition of his significant role of publicizing the University globally.
Dr. Elbatrawy was the youngest physician (29 years) to earn the State Encouragement Prize in 1997 for the sum of his research work published in international periodicals. He was then an assistant lecturer of orthopedics, Faculty of Medicine for Girls, University of Al-Azhar. Dr. Elbatrawy has many scientific international publications in the field of limb lengthening. Some of these publications are basic science studies. It is easy to find them on pubmed web site:
www.pubmed.comMany international newspapers wrote on successful surgeries performed by Dr. Elbatrawy in the respective countries. Furthermore, international TV and radio corporations such as BBC 4 (UK) and Fox News (USA) have come to Egypt to take footage of short stature lengthening operations and to conduct interviews with Dr. Elbatrawy and some of his patients from such countries, so as to have them aired in their channels. Additionally, national and Arab TV corporations have interviewed him.
Ever since 1996, Dr. Elbatrawy has performed more than 3000 successful pathological procedures and over 220 cosmetic leg lengthening procedures since 2002. Many of his foreigner patients, some of whom are international movie stars, come to CICLLR for the same purpose.
PublicationsTaylor spatial frame fixation in patients with multiple traumatic injuries: study of 57 long-bone fractures. http://www.ncbi.nlm.nih.gov/pubmed/23249891Enhancing bone healing during distraction osteogenesis with platelet-rich plasma. http://www.ncbi.nlm.nih.gov/pubmed/21513935Treatment of traumatic forearm bone loss with Ilizarov ring fixation and bone transport. http://www.ncbi.nlm.nih.gov/pubmed/16821011Deformity correction with an external fixator: ease of use and accuracy? http://www.ncbi.nlm.nih.gov/pubmed/19301808Treatment of a fibular autograft non-union with a resulting deformity by stabilization, progressive correction and callotasis using an Ilizarov fixator: a case study. http://www.ncbi.nlm.nih.gov/pubmed/22020656Correction of poliomyelitis foot deformities with Ilizarov method. http://www.ncbi.nlm.nih.gov/pubmed/21809083The new "dual osteotomy": combined open wedge and tibial tuberosity anteriorisation osteotomies. http://www.ncbi.nlm.nih.gov/pubmed/19998035Lengthening Methods (From Website):Patients with constitutional short stature or low normal stature are not treated until they have completed growing. They usually do not have deformities of the bones.
We prefer the lengthening using ring fixator (Ilizarov or Taylor Spatial frame by aid of computer software). This because when using ring fixator in our technique of maximum stability, this mentioned the highest success rate without problems or complications in more than 1000 patients we did since 1996 untill 2006. Also, it is the safest method according to the scientific publications. As many new methods are available until the moment, but all are not fully developed yet and the scientific researches mentioned some complications with these new methods. This include LON or ( Lengthening over nail method ) and fully implantable lengthening nails ( ISKD, Albizzia and Fitbone ). The usual goal of lengthening for stature for most patients with low normal stature is 2 to 3 in (5 to 7.5 cm). More than this amount of lengthening cannot be achieved safely in one pair of bones during one lengthening procedure. For more lengthening, one needs to repeat the process in a second pair of bones.
The usual strategy is to lengthen both tibiae (includes the fibula) 2 to 3 in. If a second lengthening is desired, then both femora are lengthened the same amount. Most patients do not choose to have the femora done because of the added time commitment and the doubling of the expense. Furthermore, doing too much lengthening in the lower limbs in normally proportioned people could lead to disproportion. Up to 3 inches of lengthening produces no obvious disproportion.
Recovery Duration (From Website):One can assume that it will take approximately 1 month for every inch (2.5 cm) of lengthening. Lengthening does not begin until 1 week after surgery. Therefore, 2 to 3 inches of lengthening takes 2 to 3 months. Then we have to wait until the newly formed bones are fully consolidated before frame removal. This take few months later ( the duration depends upon many factors including how many centimeters we lengthened ). Usually for 6 centimeters, it take approximately about 6 months. In some patients it took 5 months and in others took up to 7 months. When using my new technique of maximum stability, Weight bearing is permitted very early after the procedure. At the end of lengthening, the external fixators are removed from outside without need for further surgery to do this. Most patients begin weight bearing 2nd day after the surgery. Physical therapy continues, mostly to keep full ankle motion and foot push-off strength. daily exercises are recommended after the procedure for the ankle motion. This to keep the ankle always dorsiflex up to 90 degrees (minimum).
In many centers of limb lengthening all over the world including USA, they usually do not allow the patient to walk or weight bear after the operation. And the patient has to use a wheel chair for at least 4 months after the op. Then start very hard physiotherapy program to regain the lost muscles power ! As I did 3 fellowships in the best centers for limb lengthening in the world including USA, Italy and Russia and I learn a lot from Dr. Catagni in Italy, Dr. Herzenberg and Dr. Paley in Baltimore as well as in Ilizarov institute in Kurgan, I have developed my own technique in applying the ring fixators which increased the stability of the frames and minimized the common complications with external fixation as pin tract infection to be almost 0 %. In this way, I allow my patients to weight bear and walk from the second day after the operation. As my patient start to walk early, so he or she does not loose his leg muscles power and there is no need to do any special hard physiotherapy program later on.
Lengthening Cost (From Website):The cost of bilateral leg lengthening using external ring fixator start from 10,000 Euro.
This cost cover:
- Consultation fee before operation and all pre operative evaluation from the surgeon and anasthesia.
- External devices usage.
- All follow up visits.
- Frame removal procedure in the outpatient clinic.
- All follow up X rays for up to 6 months after the operation.
- All dressing tools needed during the procedure for up to 6 months after the operation.
- All hospital cost encountered with the operation for up to 4 nights of stay in the hospital.
The previous cost must be paid in advance before item 1. This cost does not include the following:
- insurance money that come back to the patient after frame removal. This is an additional 1100 euros.
- cost of physiotherapy which is about 200 $ to 250 $ per month for the first 3 months and should be paid direct to the physiotherapist based on at least two visits per week.
- Cost of accommodation in a furnished apartment in case the patient prefer to stay in Cairo after the operation either for 3 months which is the lengthening period or even till finish all the procedure till frame removal which may take totally 6 to 9 months + care taker to help. This cost depends upon the season and the standard of the rental apartment. The average cost per month for this item is 550 Euro and should be paid in advance for the first 2 months then renovated monthly 15 days in advance only before the proposed date.
- Cost of food and utilities of living as electricity bill or phone bill...etc. this is generally much lower than in Europe or USA which is about 50 % or less comparing to there.
Hospital & Accommodation (From Website):The first week after the operation, the patient stay in the hospital. This include 3 meals per day. The hospital is a very modern and well equipped medical center lies in Cairo close to the international airport. The patient stay is in a double room, air conditioned room with TV, toilet and shower.
If the patient wish to stay in a single room, so he or she has to pay 500 US $ for the whole week of the hospital stay. Then the patient is transferred to a luxurious furnished apartment with all amenities he or she needs during the following period including Satellite TV and wireless ADSL internet…etc During staying in the apartment, the patient has to pay only for the cost of his food as he or she like. Generally, food cost in Cairo is 25 % the same in any European or American city although the high quality of the restaurants and also the naturalists of it. Food will never cost more than 200 US $ per month to order food from different kind of restaurants around either by phone or via the internet where some web site available to access all local restaurants. All kind of restaurants are available: MacDonald’s, Burger King, Hardees, Pizza Hut, Papa Johns, KFC and many nice local fast food available. In addition, the lady who is the care taker can cook any kind of food the patient like.
The cost also includes using original ( FDA approval or CE certified frames ) and pins. The pins we use are the most expensive and best pins available in the medical market HA coated pins of Orthofix. Please, browse:
www.orthofix.com to understand more about. This kind of pins decrease the incidence of pin loosening or infection down to 0 %. All kind of frames we use should be marked by CE and or FDA. This means that the company produce the frame are sailing them to hospitals in USA and Europe. We never use any material that is locally made or made anywhere and is not marked by CE or FDA approved. Many other centers for limb lengthening everywhere in the world are using low cost frames either locally made or not CE marked or FDA approved. This kind of cheap frames can affect the results. We do not like to provide a cheaper cost over the quality of the material or the service provided. The quality of our work and results as well as used devices could be compared only to the same in USA and West of Europe, not to any other place over the earth where they produce more expensive operation for a much cheaper materials. Even if the final results of some other centers are good, but patient cannot know what could happen in the future for his body who had a bad quality metal for a long time which could be absorbed to the blood and make future problems.
Payment methods (From Website):Payment is either in cash or using travel checks ( in your doctor name). Other possibility is to use Bank transfer. As the system here in Egypt is different from USA or Europe, Your doctor is responsible financially about you. There is no financial deal between the patient and the hospital, but between the patient and the doctor and between the doctor and the hospital. This is very frustrating for doctors here as the doctor has to pay for the hospital, companies sailing devices and pins. He also has to pay for fees of others involved in the procedures as nurses, anesthesia doctor…etc. So, here the doctor is the responsible about everything.
Follow Up (From Website)The pain sensation is different from a person to another, however 90 % of patient has no actual pain after 3 days from the operation or during the lengthening procedure. For the first 3 days post operative, the pain management specialist like to give my patients a regular dose of Bethedine or Morphia for his or her comfort. The patient should not feel pain at any time after the surgery by using pain medication. Also, it is preferred to inject regular continuous dose of marcain or xylocain ( anesthesia ) injecting into the epidural catheter when the patient has epidural local anesthesia during the operation for the next 3 days after the op . using a special electric syring pumb. This guarantee no pain after the operation. Regular anti – inflammatory pain medication as Voltaren, Brufen…etc are not allowed to be used after the surgery. This because it affect the quality of the new bone formation, This because the new bone formation is an inflammatory process and this medicine is anti – inflammatory!
Although this surgery is considered cosmetic, we recognize that most people seeking this type of surgery are driven to do so for psychological reasons. This is clearly related to individual body image. Our psychological testing after lengthening compared with before lengthening has convinced us that in the majority of cases, stature lengthening alleviates or eliminates the neurosis the patient has before doing the operation. This neurosis is due to his or her wish to be higher. Having stated that, we have had to make an arbitrary cutoff of maximum height for which we feel comfortable offering this service. Please recognize that we are approached by individuals who are just as distressed by their perceived short stature independent of their measured height.
Other lengthening techniques (From Website):Different methods for lengthening are available. As we mentioned that we prefer external fixation method as Ilizarov ring fixator or TSF for legs and Orthofix LRS device for thighs. This because of the highest rate of success ( which reached to 100 % in our patients ). However, there are other new devices of lengthening is available as ISKD or Orthofix ( internal method of lengthening ). This allows maximum 5 centimeters of lengthening. Also the cost is higher and the patient should be completely oriented with disadvantage, obstacles or complications of this new device and also how to avoid them all.
The total cost for ISKD is fixed to 24000 US $ for bilateral application. The regular price to buy one ISKD from the company only is: 7500 US $. We see that this price of 24000 US $ totally is really a great price for those wish to apply ISKD.
*[Note]: The following is the reply from Dr Elbatrawy regarding the cost and availability of the Precice 2 for internal femurs:"Yes, Precise 2. I do in my center in Cyprus as it is not available yet outside USA and Europe."
"35000 Euro. This is the lowest cost in the world. It include 3 months of Accomodation till finishing the lengthening. In the lowest cost center in USA, it is 80 thousands of US $ without Accomodation or care ! This price will be only till end of this year because Precise 2 is very new now. Will not be less than 42000 euro later on."FAQs (From Website):1)
How frequent is the follow up after the operation?- We like to keep an eye to our patients! My assistant is available all the time to deal with any minor complain. I am also available in my clinic which is less than 100 meters away from the patient accommodation apartment. The regular follow up after the operation is as the following:
- At week 4 after the operation (about 3 weeks after starting distraction ): X-rays and check up to adjust the rate of distraction.
- At week 8 after the operation: X-rays and adjust distraction rate.
- At week 12 after the operation: X-rays and adjust the frame and bone alignment.
- At week 14 after the operation: X-rays and Final adjusting of the bone alignment.
- At week 19: X-ray and removal of the distal ring of the external fixator.
- Every 6 weeks after that till the date of frame removal which could be 7 to 8 months after the date of the surgery. This date depends on many factors such as: how many centimeters we lengthened ? What was the condition of the new bone formation in every individual patient ? Some patients make better bones than others (power of healing) however this makes no difference more than 1 month.
2)
What to do if I am smoker? Will be eligible to do the operation?- I do not like to operate at all on any smoker patient. This is because smoking negatively affects the power of healing. So, if you are smoker, please, keep yourself away from me! The alternative is to stop smoking for at least 6 months completely then you can come to be operated. We do a special investigation to detect that, so kindly do not waste your time and our time.
3)
How can I pay for the cost of the cost of the operation?- There are several methods of payment including:
- Cash in advance.
- Travellers check as American express checks.
- Regular checks (should be sent a month before the date of the operation to be able to collect it on time).
- Bank transfer.
The cheapest and lowest cost of payment is when doing a bank transfer. It is fast (takes only 3 to 4 days to arrive). It is safe and guaranteed. Our web site has been running since a long time and is impossible to have any fraud at all because we do not want to have one patient only! We want to run a good confidence with our future patients.
4)
What advantages of Bank transfer?- The most important advantage is using our services from day one of arrival including a free pick up from the airport, free consultation in the clinic including x-rays and free accommodation from day one of arrival to Cairo.
- Safety, as patient do not have to carry cash and worry about and also it is not allowed to carry cash for more than 10 thousands of US $.
- Avoid expensive interest rate when using traveler check (3 %).
However, we accept all other methods. For bank transfer, you have to contact Dr. Elbatrawy directly via his personal e-mail: ybatrawy@yahoo.com for more information about bank account.
5)
What does the total cost include:Here are approximate costs of expenses:
- Hardware or devices bilaterally cost: 8000 Euro.
- Hospital cost and anesthesia doctor fee: 3000 euro.
- Surgeon and assistance fee: 4000 euro.
- Follow up for 6 months: Free.
- Accommodation for up to 3 months is free.
- Every month after that cost extra 800 euro including follow up cost and x-rays.
It is clear now for you that it is not possible to do any installment for the cost of the operation as all the cost should be paid in advance. It is very valuable because the same operation using the same device (but definitely not using Dr. Elbatrawy special technique) in Europe or USA will cost no less than 5 times this amount! Also, very few specialists over there can have such excellent results as Dr. Elbatrawy.
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Can you describe for me day by day what will happen?Day one: Arrival to Cairo and free pick up from the airport either by Dr. Elbatrawy driver or one of his assistants.
Day two: Free consultation (also it is possible to do it in day one if you arrive early during the week days from Sunday to Wednesday).
Day 3: Doing all necessary blood investigation and x-rays.
Day 4: Doing the operation
Day 5, 6 and 7: receiving great care in one of the private medical centers where Dr. Elbatrawy admits his patients.
Day 8: Transfer to the patient’s apartment: you stay in your own separate room. You will have a nursing service and a care taker to help you with anything you need.
Day 9: You should be visited by Dr. Ibrahim who is a specialist physiotherapist for limb lengthening patient. The cost of one hour with Dr. Ibrahim is about 20 Euro and you should pay his fee directly to him. You may need his help for two hours per week in the first month then one hour per week later on. You can buy the food you like or ask the care taker to cook for you what you like. You will have to start lengthening from day 10 after the operation in a rate of ¾ mm. per day. Your doctor will teach you how to do this successfully.
Day 10 to 30: Enjoy using the walker going to the very close city stars mall:
http://www.citystars.com.egDay 31: The date of the first follow up x-rays and adjusting the lengthening rate.
Day 60: The second follow up x-rays.
Day 90: The third follow up date and adjusting the bone alignment if needed.
Day 100: The final follow up and locking the frame.
By that day you will be able to go back to your home and just follow up with a local doctor or with doctor Elbatrawy either in Cairo or in your home ( Dr. Elbatrawy accept to come to you for follow up and possible to arrange the cost for that with him directly ). You may need 2 to 4 follow up visits till final frame removal.
7)
Is CICLLR a hospital?- No, CICLLR is Dr. Elbatrawy clinic where he is following up and meeting his patients. It lies in 8 Elnozha street, Madinet Nasr area just infront of the Airforce defence house and hotel Tiba rose. It is just 100 meters away from Holiday Inn Heliopolis hotel and city stars huge mall.
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So where will Dr. Elbatrawy do my operation?- Dr. Elbatrawy is a university professor and he works in the university hospital which accept patients who are covered by the insurance or the government only and he admits his private patients in 3 different state of art medical centers. One of them is the prestigious IMC:
www.imceg.com however you will not find information about the procedure on that web site simply because it is moderated by the army and it is not allowed to add information about private doctors operating there. Also, he operates in Elnozha international hospital and Safwat Elgolf private hospital. All these medical centers have ISO certificate and all of them are fully equipped with the most modern technology equipments. In any one of them, you will enjoy a very friendly atmosphere from the staff and the nurses who like to talk to foreign patients. You will find that most of staff can speak good English. Some also speak French, Dutch and some speak Italian.
9)
How to manage the pain after the operation?- Dr. Elbatrawy is a very human being person and he will never leave you in pain ! So, do not worry about this and he guarantees that his technique of maximum stability has the lowest pain among all others techniques. We do not want to write our special technique details of how to manage the post operative pain but we guarantee a pain free rehabilitation after the operation. It is very tolerable, do not worry. But remember: NO GAIN WITHOUT PAIN ! We do not want our patients to go through any pain and we care a lot about this matter.
10)
Are you a suitable or a good candidate for cosmetic lengthening?- If you fulfill the following criteria then you are a candidate for lengthening:
- Age: from 14 to 60.
- Non smoker or stopped smoking for the last 6 months before starting the procedure. We do tests to detect that has smoking proved to affect negatively the new bone formation and the speed of healing and consolidation (can take longer time with smokers).
- Not overweight.
- Have no systemic disease as: Rheumatoid arthritis or Diabetes Mellitus, HIV positive, systemic lupus or any other systemic disease thatn can affect the lengthening procedure success.
- Psychologically free: A meeting with a psychologist for evaluation could be arranged before the procedure to prove your eligibility for the procedure from the psychological point of view. From our previous experience with cosmetic lengthening patients, we found that it is important in some patients to study their fitness and eligibility psychologically for the lengthening procedure.
11)
How long you should stay in Cairo?- Although it is preferred, but it is not necessary to stay in Cairo during the entire duration of the procedure till frame or implant removal.
Many of Dr. Elbatrawy patients did the operation in Cairo and travelled back to their homes just after a week after it. Then they do the follow up every 40 to 45 days either with Dr. Elbatrawy or with a local Orthopedic surgeon who is oriented with lengthening and under the supervision of Dr. Elbatrawy himself either during the follow up visit or via e.mail. Many patients from Europe and USA choose this option.
Also, many patients preferred to stay in Cairo for the lengthening period only (about 3months) then they traveled back home. 3 to 4 months later Dr. Elbatrawy arranges their frame removal either in his clinic in Cairo or in their homes or by a local specialist. It is an easy procedure and does not need a surgical operating room. Frame removal is free of charge in Dr. Elbatrawy clinic.
All follow up visit in CICLLR including x-rays are free of charge.
We guarantee excellent results, so we never calculate cost of any additional procedure needed to treat a complication! Simply because WE DO NOT HAVE ANY.
Only in case the patient lengthened more than 6 centimeters and he or she needs for an additional minor operation to lengthen tendo achelis (to avoid ballerina foot problem ) as this could happen in about 30 % of patients lengthen more than 6 centimeters ( 2.5 inches ). Then the cost of this operation is only 3500 Euro including hospitalization for one day.
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Payment methods?- Payment is either in cash or using travel checks ( in your doctor name). Other possibility is to use Bank transfer ( Most of patients do that because it is the cheapest way ). As the system here in Egypt is different from USA or Europe, Your doctor is responsible financially about you in front of the hospital. There is no financial deal between the patient and the hospital, but between the patient and the doctor and then between the doctor and the hospital. This is very frustrating for doctors here as the doctor has to pay for the hospital, companies sailing devices and pins. He also has to pay for fees of others involved in the procedures as nurses, anesthesia doctor…etc. So, here the doctor is the responsible about everything financially regarding his patient.
Contact InformationDr. Yasser Elbatrawy
8, Nozha St., Nasr City, Cairo
Mobile : +20 100 1435969
Office : +202 24141713
Fax : +202 24141712
E-mail : ybatrawy@yahoo.com
(N.B. Dr. Batrawy checks his e-mails personally. He can receive your messages in Arabic or English, but his reply will be in English only).
Websitewww.lengthening.org