March 12, 2026
3 min read
Add Us On GoogleAdd SciAm
‘Like knives inside my body’: How a new ultrasound simulator could help doctors better diagnose endometriosis
A company that makes surgical simulators released a tool to train clinicians to diagnose a deep form of endometriosis
“To me was like knives inside my body—like someone studying me from the inside.” That’s how Noémie Elhadad describes the pain of endometriosis, a condition she has lived with since she was a teenager. Now an associate professor of biomedical informatics at Columbia University, Elhadad is far from alone. Endometriosis—a condition where the tissue lining the uterus grows outside of it—affects an estimated 10 percent of people with uteruses of reproductive age worldwide. Its symptoms include severe pelvic pain, infertility and pain during sex.
It often takes years for people to get a diagnosis, if ever, and there are few treatments available apart from menstruation suppression, pain management and surgery. Elhadad studies AI and medicine and has developed an app that surveys people with endometriosis about their symptoms. She says that in her experience, “there have been episodes where I nearly felt I was dying.”
Now, Swedish company Surgical Science has developed a device designed to better train clinicians to recognize signs of the disease using ultrasound. Making endometriosis diagnosis more accessible could lead to earlier treatment, says Katie Jenner, senior director of the product management team for Surgical Science’s endometriosis simulator, whose new module was announced today.
On supporting science journalism
If you’re enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.
“We are on a mission to democratize ultrasound education and training,” she says.
Historically, the gold standard for diagnosing endometriosis has been surgery, through small cuts made in the abdomen. But surgery is still invasive and inaccessible to some patients, and many clinicians instead rely on symptoms alone to make a diagnosis. And while some have turned to noninvasive imaging methods such as magnetic resonance imaging (MRI) and transvaginal ultrasound very few doctors receive enough training in how to use ultrasound to diagnose endometriosis. Surgical Science’s endometriosis ultrasound simulator aims to change that.
Part of why it is so hard to diagnose endometriosis using imaging has to do with how the disease manifests. There are three main types of endometriosis. Ovarian endometriomas, also called “chocolate cysts,” are benign blood-filled cysts on the ovaries that are fairly easy to detect on an ultrasound. Deep endometriosis is a more aggressive form in which endometrial tissue invades other organs, such as the bowel and bladder; it’s detectable on an ultrasound, but most gynecologists and surgeons aren’t trained to do that. Superficial endometriosis, meanwhile, is the most common form of the disease and also the hardest to detect, causing shallow lesions on the membrane that lines the abdominal cavity that are hard to see on ultrasound or MRI.
Surgical Science has a new simulator module that incorporates a feature known as the “sliding sign,” which can help better diagnose deep endometriosis. Deep endometriosis causes scar tissue in organs around the uterus. If pressure from the ultrasound wand causes organs in this area to glide smoothly, that suggests there are no adhesions. But if there is stiff tissue, that can indicate adhesions—and the presence of endometriosis.
According to surveys at workshops where Surgical Science’s simulator was used, 92 percent of clinicians reported improved understanding of endometriosis diagnosis. And there was a 150 percent increase in confidence in identifying deep endometriosis.
“Better training means faster, more reliable detection,” Surgical Science CEO Tom Englund said in a statement.
Currently, the simulator cannot train clinicians to diagnose superficial endometriosis. And ultrasound still lacks the resolution that MRI or surgery can provide. But it’s a step in the right direction, Elhadad says. After all, people with endometriosis often have their pain dismissed or normalized.
“Having access to the diagnosis gives you access to early interventions,” she says. “And I think that’s a very useful thing.”
It’s Time to Stand Up for Science
If you enjoyed this article, I’d like to ask for your support. Scientific American has served as an advocate for science and industry for 180 years, and right now may be the most critical moment in that two-century history.
I’ve been a Scientific American subscriber since I was 12 years old, and it helped shape the way I look at the world. SciAm always educates and delights me, and inspires a sense of awe for our vast, beautiful universe. I hope it does that for you, too.
If you subscribe to Scientific American, you help ensure that our coverage is centered on meaningful research and discovery; that we have the resources to report on the decisions that threaten labs across the U.S.; and that we support both budding and working scientists at a time when the value of science itself too often goes unrecognized.
In return, you get essential news, captivating podcasts, brilliant infographics, can’t-miss newsletters, must-watch videos, challenging games, and the science world’s best writing and reporting. You can even gift someone a subscription.
There has never been a more important time for us to stand up and show why science matters. I hope you’ll support us in that mission.
