Have you ever struggled with identifying the muscle ends in a complicated repair? 🤓👆
The legendary Abdul Sultan showed us this helpful tip for identifying the ends of the external anal sphincter: Grasp each muscle end with Allis forceps, and palpate the anal opening while lifting the forceps. If the EAS is identified correctly, you will now feel your finger being lifted.
If you accidentally get the Allis clamp caught in the superficial transverse perineal muscle on one side and the external anal sphincter is held with an Allis clamp on the other side, there won't be a symmetric lift around your finger inside the anus.
Thus, the finger-lift test can help you identify with certainty whether you have correctly identified the muscle edges from the external anal sphincter with the Allis clamps BEFORE you start suturing.