🩸 Laparoscopic Endometriosis Staging Simulator

Minimal Endometriosis — rASRM Stage I

Few superficial implants, score 1–5, no meaningful adhesions.

• 1–5: Score Range (rASRM points)
• Superficial: Lesion Depth (peritoneal implants)
• None: Adhesions (filmy or absent)
• Low: Fertility Impact (mild association)

Lesion appearance

Small, scattered superficial implants dot the peritoneum.

Adhesion status

Pelvic anatomy stays essentially normal and mobile.

Clinical significance

Often found incidentally during unrelated laparoscopy.

Stage I rarely explains pelvic pain by itself.

Mild Endometriosis — rASRM Stage II

More superficial implants, score 6–15, mild adhesions appear.

• 6–15: Score Range (rASRM points)
• Superficial–shallow: Lesion Depth (expanding implants)
• Mild, filmy: Adhesions (early tethering)
• Modest: Fertility Impact (still manageable)

Lesion burden

Implant number and depth increase gradually.

Early adhesions

Thin filmy bands begin tethering ovary to pelvis.

Symptom pattern

Pain remains mild or intermittent for most.

Diagnosis still requires direct laparoscopic visualization.

Moderate Endometriosis — rASRM Stage III

Deeper implants, endometriomas form, score 16–40.

• 16–40: Score Range (rASRM points)
• <2 cm: Endometrioma Size (per ovary)
• Moderate: Adhesions (dense in spots)
• Significant: Fertility Impact (surgical planning needed)

Deep implants

Lesions invade below the peritoneal surface.

Ovarian endometriomas

Chocolate cysts distort normal ovarian architecture.

Adhesion density

Dense bands start restricting pelvic organ mobility.

Endometriomas weigh heavily toward Stage III–IV totals.

Severe Endometriosis — rASRM Stage IV

Deep implants, large endometriomas, dense adhesions, score over 40.

• >40: Score Range (rASRM points)
• >2 cm: Endometrioma Size (often bilateral)
• Dense: Adhesions (organ-obliterating)
• High: Fertility Impact (complex surgical care)

Extensive disease

Lesions and cysts cover wide pelvic surfaces.

Frozen pelvis

Dense adhesions can obliterate the cul-de-sac.

Surgical complexity

Excision often needs multidisciplinary surgical teams.

Stage IV correlates most strongly with infertility risk.

Surgical Staging Complete

Your slider totals now set the final rASRM stage.

• 1–150: Score Range (full rASRM scale)
• 4: Classification Tiers (stages I–IV)
• 3: Criteria Scored (location, depth, adhesions)
• Laparoscopy: Gold Standard (direct visualization)

Scoring basis

Points sum lesion size, depth, and adhesion severity.

Stage thresholds

Totals of 1–5, 6–15, 16–40, and 40+ define stages.

Treatment planning

Stage guides surgical extent and fertility counseling.

Adjust the sliders above to explore every staging outcome.