S-MAP (Systematic Mapping of the Abdomen and Pelvis)
S-MAP (Systematic Mapping of the Abdomen and Pelvis) is an operative protocol developed within NaProTechnology and refined by IIRRM-trained surgeons that requires a structured, sequential inspection of all abdominal and pelvic regions before any surgical intervention begins. The protocol establishes a reproducible examination sequence: every anatomic region is evaluated before excision, lysis, or reconstruction, so that no area of disease is passed over in the urgency of addressing the most visible pathology first.
The clinical rationale is direct. Surgeons who proceed immediately to obvious disease risk missing concurrent pathology in regions not yet examined. Endometriosis is rarely confined to a single location. Adhesions, diaphragmatic implants, appendiceal involvement, and upper abdominal disease are found at laparoscopy in a proportion of patients with pelvic pain or infertility that would surprise a surgeon who only looks where the patient reports pain. A systematic pre-intervention map changes what gets found. What gets found changes what gets treated.
S-MAP is performed in combination with near-contact laparoscopy. Close-approach visualization at each anatomic region, following the protocol sequence, allows identification of subtle or atypical lesions that standard-distance inspection would miss. The two techniques are complementary: near-contact provides resolution; S-MAP provides coverage. Together they address the two most common sources of surgical failure in endometriosis surgery: missed lesions and skipped regions.
S-MAP is an operative protocol within the NaProTechnology surgical framework and IIRRM training curriculum. It is applied in the context of diagnostic and operative laparoscopy and is part of the broader philosophy of pelvic excision and repair surgery. Training in the specific protocol sequence and anatomic mapping criteria is delivered through the IIRRM surgical training program. Couples seeking surgeons familiar with systematic pelvic mapping can look for providers with NaProTechnology surgical fellowship or IIRRM operative training.
This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.