Dr. Phil Gachassin

Innovative Surgeon Goes Entrepreneur

When it comes to surgical procedures, Dr. Phil Gachassin has always been on the cutting-edge. Since starting his general surgery practice, he has specialized in minimally invasive gastrointestinal techniques and weight loss surgery. Once the da Vinci® robot came onto the market, he was one of only a handful of Acadiana doctors to do robotic gastrointestinal surgery. In 2010, he became the first physician in Lafayette to perform Transoral Incisionless Fundoplication (TIF) with EsophyX®.
TIF® is an incisionless procedure for the treatment of gastroesophageal reflux disease, one of the most common conditions in the U.S. Patients suffering from small hiatal hernias, or who are just sick and tired of taking medications for GERD, are candidates for the procedure.
Using the EsophyX surgical device made by EndoGastric Solutions, Gachassin goes through the patient's mouth into the stomach. With the manipulator on the end of the EsophyX, he forms tissue folds, then sutures through the device to create a new valve at the junction of the esophagus and stomach. This establishes a barrier to reflux, which effectively eliminates GERD. "This device is novel because it is able to do a surgical manipulation of the tissue at the gastroesophageal junction to prevent the reflux disease," Gachassin explained. "So, when you are eating, that's a one-way valve and food will go down, but food won't come up."
Compared to the open or laparoscopic procedures, patients' recovery time with the incisionless surgery is significantly reduced. With open surgery, recovery takes four to six weeks. Laparoscopic cuts that time to two weeks. But, patients treated with EsophyX can go home the next day. "There are no incisions, so there's faster recovery, no pain, and much less risk of blood loss or herniation," Gachassin said.
After training with the device last year, Gachassin started doing the incisionless surgery in 2010. Physicians in Crowley, Baton Rouge, Lake Charles, Thibodaux and Covington have also been trained with the EsophyX. Gachassin's transoral surgical candidates this year had been on medications for over 20 years. Since having the procedure, they have not taken any medications.
The EsophyX procedure is an example of a natural orifice surgery (NOS). Other NOS procedures involve using the mouth to go down into the stomach, cutting a hole in the stomach to remove organs like the gall bladder, and closing the hole on the way out. Surgeons have also done NOS procedures laparoscopically by placing a camera and instruments through the vagina and going into the abdomen to extract portions of the colon or the stomach. "The EsophyX operation is the first one in a long series of what's going to come with natural orifice surgeries," Gachassin reported. "This is kind of a neat device, and there are going to be many more devices like this in the future that we may use to do certain types of weight loss surgery." Gachassin's partner, Dr. Dennis Eschete, Jr., is already performing transoral weight loss surgery with the StomaphyX®, also manufactured by EndoGastric Solutions.
Growing up in Lafayette with an attorney father, Gachassin always thought that he would purse the legal path. But, while attending college at Tulane University, he realized that science was his strength. During the summer in undergraduate school, he worked in surgery at a hospital. That's when he realized his calling to become a gastrointestinal surgeon. After graduating from the Louisiana State University School of Medicine in New Orleans, he did his residency at the University of South Alabama in Mobile. Following his training, he practiced in surgery in Metairie for two years before returning to his roots to practice in Lafayette in 2004.
Ironically, Gachassin married an attorney, Jessica, who is currently of counsel with the Johnson Gray McNamara law firm. The couple has two boys – Jacques, 4, and Turner, 2. When not working, Gachassin enjoys duck hunting, fishing and spending as much time as possible with his kids. Professionally, he is serving as president of the medical staff and a board member at Lafayette General Medical Center.
Last year, Gachassin and his brothers – Nick, an attorney, and Greg, a mortgage broker/developer – entered into their first business venture together. In 2009, they launched the Wingate by Wyndham, a hotel geared toward business travelers. Despite opening during shaky economic times, the hotel is doing well. "Business has been good; we've been very happy so far," he reported. "It's improving all the time."
Gachassin hopes to do other projects with his siblings. "It's fun," he said.

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