The Rural American Surgeon

The Truth About Surgical Responsibility with Dr. Adrian Sava


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What happens when a seasoned Swedish surgeon shares his global perspective on bariatrics, rural surgery, and the personal cost of a life in the OR?

In this episode, Dr. Randy Lehman welcomes Dr. Adrian Sava, a bariatric and general surgeon based in southern Sweden. With nearly 30 years in surgery, Dr. Sava reflects on his journey through academic training, private practice, and cross-border rural surgery in Norway.

They dig into technical details of the Roux-en-Y gastric bypass, debate the role of robotic surgery, and compare healthcare systems between Europe and the U.S. 

But this episode isn’t just about operations…it’s about finding balance, maintaining humility, and preserving purpose in a high-stakes profession.

Dr. Sava opens up about family sacrifice, burnout, and faith—sharing how a CT-negative fishbone reaffirmed his trust in clinical instinct, and how a difficult colostomy case helped him regain perspective on the balance between professional duty and personal identity.


0:00 Intro
1:11 Dr. Sava’s Background and Surgical Training
6:57 Practicing Bariatrics in Sweden
13:42 Swedish vs. American Rural Surgery
17:04 Private Practice, Public Insurance, and the Economics of Care
26:56 Why Surgery Is Special to Dr. Sava
30:55 How I Do It: Roux-en-Y Gastric Bypass
55:45 Financial Corner: Surviving Surgery with Discipline
59:13 Classic Surgery Stories from Sweden
1:07:06 Resources for the Busy Rural Surgeon
1:13:12 Finding Balance Through Faith

Resources Mentioned:

IFSO Congress (International Federation for the Surgery of Obesity and Metabolic Disorders): https://www.ifso.com/

Swedish College of Surgeons


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The Rural American SurgeonBy Randy Lehman