First of all, it should be noted that not all patients with varicose veins need surgery, but only if strict medical treatment does not work, or if the patient wants a radical cure according to their needs. Can surgery be cured without surgery? Patients with early varicose veins, graded from C0 to C3 (refer to the article “How do you know you have varicose veins? ), if the condition is not very serious, you can choose conservative treatment, that is, non-surgical treatment. The specific methods include lifestyle changes, wearing compression stockings, and taking medication. First of all, patients can reduce the standing time, rest more, massage the legs more, obese patients should lose weight, sleep on the affected limbs to enhance the venous return; and compression therapy, that is, wearing elastic stockings (refer to the article “How to wear elastic stockings for varicose veins patients? ), which can relieve the symptoms of varicose veins to a certain extent and slow down the disease process. If wearing elastic stockings can reduce the progress of varicose veins to an acceptable rate, then combined with the patient’s age, physical condition and other factors, surgery may not be necessary (this is judged by the professional doctor); another method is to take medication, but the effect of taking medication alone is relatively small, because most of the medication is symptomatic treatment, such as reducing edema, improving skin nutrition and reducing pigmentation. The duration of medication is usually 3~4 months. Some drugs can also theoretically repair the damaged vein walls, but the effect is ultimately limited and does not reach the intensity of the effect of compression stockings. These conservative treatments need to be used in combination to improve the varicose veins to some extent. If the varicose veins are still not under control, if the progress is still fast, if the varicose veins are more extensive and heavy, if there is even soreness and swelling, pigmentation, repeated redness, swelling, pain, rash and rupture in the lower legs, and if the grade reaches C3 to C6, then surgery should be considered. If the conservative treatment is not good, you can only “do surgery” The vascular surgery department of Chaoyang Hospital mainly carries out the following varicose vein surgery methods, which are listed below: Saphenous vein high ligation + stripping: this is the most traditional, the most classic, and also one of the more effective surgical methods, this surgery is applicable to a wide range, basically all This procedure is suitable for all patients (there are certain requirements for age and physical condition, high age and weak physical condition may not tolerate the surgery). However, compared to the newer surgical methods, this traditional surgery is more aesthetically displeasing because of the number of incisions (the surgery makes punctiform incisions in the branches of the varicose vein masses), and some patients cannot accept the appearance of their legs after the surgery. Transilluminated spinotomy + inversion stripping (or normal stripping): This is a very mature procedure carried out by the vascular surgery department of Chaoyang Hospital (refer to the article “Tiny incisions for varicose veins – transilluminated spinotomy”), compared to the traditional multiple incisions, transilluminated spinotomy only requires poking 1-2 small holes in the varicose vein mass, and then inserting the spinotomy head into the vein mass to break it up. The broken varicose tissue is then aspirated (the saphenous vein trunk still needs to be dissected internally or by normal dissection). Although some patients may not recover as quickly as with traditional surgery, this procedure has fewer incisions and is more aesthetically pleasing. Laser treatment: Laser treatment is not really suitable for dealing with coarse vessels, it is suitable for patients with less severe varicose veins and higher aesthetic requirements. I usually treat the varicose branches with spinotomy or sclerotherapy after laser closure of the main trunk of the saphenous vein. Similar treatments to laser are radiofrequency, microwave, and electrocoagulation. Foam sclerotherapy: This is mainly for patients who cannot tolerate surgery, such as those who are older or in poor health, or those who have milder symptoms and have higher aesthetic requirements. Foam sclerotherapy for varicose veins is less invasive but has a high chance of recurrence and is often incomplete, so it is generally used as a complementary tool or to treat residual and recurrent veins. With these four surgical treatment modalities, the surgery is less invasive in order, but less thorough in order. These treatment modalities can be chosen as one or a combination of several, and the choice of the specific surgical modality needs to be communicated between the patient and the doctor. One more point needs to be made here: if a pregnant woman has varicose veins, it is not recommended that she have surgery during pregnancy, not only because of the safety factors of the pregnant woman, but also because of some factors such as hormone levels and increased abdominal pressure during pregnancy that need to be considered. So my recommendation is to wait until 3 months after delivery and then re-evaluate the varicose veins in pregnant women, by which time most patients’ varicose veins will have improved significantly and surgery will not be necessary.