Lower extremity saphenous varicose vein is a common and frequent disease in vascular surgery, which is a venous backflow disease of the lower extremity caused by saphenous valve insufficiency. The main manifestation is the appearance of worm-like tortuous venous masses on the inner side of the lower limbs, accompanied by soreness and swelling of the affected limbs when standing and walking. Although this disease does not lead to serious consequences such as limb necrosis and amputation, if not actively treated, it can cause eczema-like changes in the lower leg skin, pronounced itching, skin pigmentation, thrombotic superficial phlebitis, acute bleeding and persistent ulcers (commonly known as old rotten legs), which seriously affects the quality of life of patients. Figure 1 Bilateral varicose saphenous vein, more severe on the right side, with skin pigmentation in the foot and boot area. Figure 2 Chronic ulcer caused by saphenous varicose vein with obvious pigmentation of the surrounding skin. Figure 3 Calf ulcer caused by saphenous varicose vein with traffic vein stitching, stitches removed. Figure 4 Ulcer in the boot area caused by saphenous varicose vein, with hyperpigmentation of the surrounding skin and eczema-like changes, after suture ligation of the traffic vein. Figure 5 Giant ulcer in the foot and shoe area caused by saphenous varicose vein. Currently, although there are many treatments for saphenous varicose veins, the most definitive and effective therapy remains minimally invasive surgical treatment, i.e., small incision saphenous vein ligation and stripping in high level. Common treatments include traditional surgical excision, laser therapy, sclerotherapy, and wearing medical compression stockings. Traditional surgery has a large incision, long bed time, and is prone to complications such as deep vein thrombosis in the lower extremities, and is often performed by non-vascular surgeons, resulting in a high recurrence rate after surgery. After laser treatment, the saphenous vein remains in the body, and the five branches of the root of the saphenous vein cannot be treated, so the recurrence rate is higher after surgery, and medical elastic stockings need to be worn after surgery. Sclerotherapy is only applicable to the superficial varicose veins remaining after saphenous vein surgery, because it is difficult to occlude the main trunk of saphenous vein, the recurrence rate is very high simply by applying sclerotherapy, and it brings great difficulties to the surgical treatment. Wearing medical elastic stockings can only prevent further aggravation of saphenous varicose veins, but not improve the existing varicose veins. Finally, it should be clearly pointed out that there are no drugs for saphenous varicose veins and any drug treatment is ineffective. Our minimally invasive surgical treatment, namely small incision saphenous vein ligation and stripping, is the most definitive and effective method of treating varicose veins. The operation uses advanced saphenous vein stripper, which can completely and thoroughly strip the main trunk of the saphenous vein and the superficial varicose veins, and it is the treatment with the lowest recurrence rate. The surgical incision is very small, and the absorbable suture is applied intradermally, so there is no need to remove the suture. The postoperative recovery is fast, and the patient can go down to the ground on the day of surgery, which can effectively prevent the formation of deep vein thrombosis in the lower limbs, and can be discharged from the hospital in 2~3 days, and the hospital stay is less than one week. The surgical incision scar is very small and does not affect young female patients wearing skirts. Figure 6 Patient of Figure 1, after bilateral small incision saphenous vein high ligation and stripping, the varicose vein mass completely disappeared, the incision was very small and healed well. Figure 7 Patient in Figure 2, after high saphenous vein ligation and stripping with small incisions and suturing of the traffic vein around the ulcer, the tortuous vein mass completely disappeared and the ulcer was smaller than before. Figure 8 In the same patient, two weeks after surgery, the ulcer was significantly smaller than before, and the wound surface was neat and freshly granulated. Figure 9 The same patient, 3 weeks after surgery, the calf ulcer was completely healed. Figure 14 Double severe saphenous varicose veins with left-sided superficial thrombophlebitis Figure 15 The same patient, 3 days after the operation, the memory tortuous vein masses in both lower limbs completely disappeared and the incision healed well. Figure 16 The same patient, 1 month after the operation, the medial tortuous vein masses in both lower extremities completely disappeared and the incision was not obvious, and she has completely returned to normal life.