I totally understand what you are saying, and yes helping others is my main goal as well. I did do research, tons on CRS's that do AD, and the closest one I could find was over 400 miles away. I am a nurse for 22 years, and believe me, I also did my research on LIS also, I did not want to be cut if not needed, but I had no choice. I spoke to many of the surgeons in my area, though a couple of the general surgeons did the proceedure, I opted to go to a CRS who does this all the time, hence the 90 mile ride. I totally understand the managed healthcare system and Dr's unfortunately are being told how to run their practices by the insurance companies. here in the US. I have dealt with that for 22 years. We are behind other countries like Japan and Germany when it comes to stuff like this but we have to deal with it b/c this is where we live. The little town I live in is 10 years behind Baltimore. Unfortunately, every surgery comes with the risk of infection, complications, but for me I was willing to risk it, I just couldn't live like that anymore. So on post op day 5, I am getting ready to go to the bank and grocery store...I will say though, I am not ready for a game of flag football!!! LOL

wecc and Sue - I think you both have valuable info to share . . . both of you can give firsthand accounts of BOTH procedures.
There might be some of us who won't be able to do whatever it takes to have the AD, due to there not being enough trained crs around the U.S. who perform this. So, the last resort there would be the LIS. === But, there might be others here who can find (or can travel to) a good crs who performs AD.
I'm still hoping this darned fissure heals on its own. TBH, I don't know at this point, because I'm already 3 months into this now. --- HOWEVER, if I need to seek additional treatment, then it's good to know that both of you can give your accounts and details of how you're doing and what your respective procedures were like.
wecc - I'm wondering what granny is wondering, too . . . is the AD considered a permanent type of procedure? - in other words, it doesn't have to be repeated on a regular basis? Since the anal area has muscles, it makes sense that muscles can be stretched - but is it long lasting?
Thank you, both, for your info, btw. I've been coming here every day, for a little while now, and it's what I hang onto, to try to get through this time in my life.

From my understand what a LIS does is it expands the sphincter and reduces the resting pressure thus allow the fissure heal This is done by cutting the muscle. The AD in effect does the same thing by pulling apart those muscle fibers. The goal is to let the fissure heal. Both my CRS that preformed the AD, as well as the one that was going to do the LIS said that contrary to belief, an LIS does not stop you from developing another fissure. So regardless whichever you decided to do, you must change your life style and get your BM’s to where they are not hard and do not strain. That is the real way to heal and kept the fissure away
Sue, I fully understand and appreciate your point. I was is so much pain that I was all set for an LIS. Again I am not saying do not have an LIS, my point there is just another options out there that for whatever reason is not mainstream here as it is in other places and that it is not necessary because the LIS is better.
I believe you should set your goal …flag football one month:) ??? BTW, Maryland is a wonderful state…I have a good opportunity to visit many areas when I could. I attended the USNA.

You are absolutely correct about the LIS proceedure, the incision, usually 5mm, expands the internal sphincter to reduce the resting pressure so the fissure can heal. Believe me, I found out as much as I could before doing it. How about 2 weeks :0) on the football!!LOL... I live near Ocean City, so if you have been on the lower slower Eastern Shore you know what I am talking about, about being behind everywhere else medically speaking. I will say, I am originally from Westport, CT a little town that is a suburb of NYC and this was quite a change, but a great place to raise a family, but I do miss being able to go to the city. Ahhhh USNA, my brother is a SEAL. I totally agree with you, there should be other options more readily available for people going through this. Maybe in the future, there will be.

Wow, my husband I were just discussing this must be the "Worlds Best Kept Secret."
Can't imagine why there aren't more post in this forum from Germany, Japan, or NYC on this procedure... Who knows?! Maybe because it's so successful, that the folks who have had it- don't feel the need to post in a forum or need support. Maybe because, (possibly just like the millions of people all over the US and the World who have a successful LIS , they don't need support at all or post in a forum?!!
It's really good of you to share you're experience. It's rare that folks who have had positive experience stick around. I felt the same as you after my LIS and wanted others to know that there's no need to suffer, there is a light at the end of the tunnel.

There is some research results shown here. :
http://www.recentmedicalfindings.com/h93w/forced-manual-dilatation-of-anus-procedure-5.html
Strange that they call it 'forced manual dilation' as though any other surgery performed on that area is not a form of force. But, be that as it may. I am going to continue research into what wecc has had done. If I can avoid having surgery of the cutting variety, I am willing to take the risk. I have had too many surgeries on my 'rear' which has put me off having more.

Has anyone read this one?
http://www.nejm.org/doi/full/10.1056/NEJM199806043382314

That's a great find Sweet! The most detailed information that I've seen yet. Thanks for posting!

I hope it helps. I would love to find a crs who can perform that here in my area (Central CA).

Hopefully you will. This procedure isn't anything new. As far as I'm understanding it's been around since 1990's. I've only came across three people in this forum who have had it. One from the US, one from Germany and one from India.
There was a guy in here who had the older uncontrolled method and had success. I believe his name was Dell...
Here's another link-
http://www.ncbi.nlm.nih.gov/pubmed/15690668
Wikipedia-
Anal dilation, or stretching of the anal canal (Lord's operation) has fallen out of favour in recent years, primarily due to the perceived unacceptably high incidence of fecal incontinence.[20] In addition, anal stretching can increase the rate of flatus incontinence.[21]
**** In the early 1990s, however, a repeatable method of anal dilation proved to be very effective and showed a very low incidence of side effects.[22] Since then, at least one other controlled, randomized study has shown there to be little difference in healing rates and complications between controlled anal dilation and LIS,[23] while another has again shown high success rates with anal dilation coupled with low incidence of side effects.[24]****
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099002/
More recently, an attempt was made to standardize anal dilatation with pressurized balloons (controlled pneumatic dilatation) to reduce the incidence of sphincter injury [67, 68] with appreciable results. In Italian clinical practice, anal dilators are frequently used, although there is very little scientific evidence regarding the benefits of this treatment [69].