Surgery has always been the main method of treating varicose veins, but in recent years, with the emergence of minimally invasive treatment methods, a variety of propaganda has caused many patients to be at a loss as to what kind of surgical methods are effective. To answer this question, it is necessary to understand the physiological anatomy of the venous system of the lower extremities. The main pathogenesis of varicose veins is the incomplete closure of the valves of these three systems, which leads to the backflow of blood from the veins and the continuous increase of pressure in the veins. Numerous in-depth clinical studies have confirmed that not all patients with varicose veins have problems with the valves of all three systems, and that about 10-15% of patients only have incomplete closure of the valves of the superficial venous system. Therefore, the system in which the valve lesion occurs and the severity of the valve lesion is the main basis for choosing a different surgical approach. At present, the main surgical modalities for the treatment of varicose veins are: Zhou Tao, Department of Peripheral Vascular Medicine, First Affiliated Hospital of Henan College of Traditional Chinese Medicine Saphenous vein or small saphenous vein high ligation and stripping: It is the classic procedure for varicose veins in the lower extremities and can be used in all patients with superficial venous valve closure insufficiency. It is characterized by its efficacy, but has the disadvantage of being more invasive, prone to subcutaneous hematoma and damage to local sensory nerves. Endovenous laser closure (EVLT): Used to treat patients with incomplete closure of superficial venous valves. A special wavelength laser is used to close the saphenous vein through fiber optic intervention into the main trunk of the vein. This technique avoids, to some extent, the complications of hematoma and nerve damage associated with aspiration of the saphenous vein. Other techniques with similar treatment principles as the laser are radiofrequency closure and electrocoagulation closure. All three techniques have in common the avoidance of saphenous vein stripping, but they cannot help with varicose veins in the lower legs and often have to be combined with traditional stripping surgery. Also, although less invasive, there is a higher rate of distant recurrence after surgery. Trivex: Designed for patients with extensive varicose veins in the lower leg, the Trivex technique uses a subcutaneous light source to locate the varicose veins and then uses a tare system to remove them. This technique solves the problem of varicose veins in the lower leg by making only 2 incisions in the lower leg. However, the aspiration technique is not suitable for the treatment of the main saphenous vein. Also the planar aspiration is not strictly minimally invasive, it appears to have few and small incisions but the subcutaneous trauma is greater. Deep vein valve repair: This is used to treat patients with deep vein valve insufficiency. The repair methods are ① endoluminal valve repair; ②external valve repair; ③ venous valve grafting; ④ venous valve transposition, currently the commonly used method is external valve repair or “ringing”. Traffic branch vein dissection (ligation): It is suitable for patients with skin stasis and ulcers caused by the insufficiency of traffic branch vein valves. It is one of the most important tools in the treatment of venous ulcers and recurrent varicose veins in the lower extremities. It can be seen that although there are many surgical methods for treating varicose veins, each has its own clear indications, and only by using individualized surgical combination patterns for the specific conditions of patients can good clinical results be achieved.