Surgery is the most definitive treatment method for varicocele. Varicocele with significant symptoms or with abnormal semen and infertility should be considered as an indication for surgery. The conventional surgical approach is to ligate and cut the internal spermatic vein at a high level at the level of the retroperitoneal, inguinal canal internal ring. Both retroperitoneal and laparoscopic high ligation of the spermatic veins are simple and effective, and both are commonly used in the treatment of varicocele in China at present. However, both of these surgical methods cannot deal with the lateral branch veins parallel to the groin and peritoneum, and the internal spermatic artery is also often misligated, and the accompanying lymphatic vessels are often ligated, causing scrotal edema and the hidden risk of testicular atrophy. Laparoscopic surgery in the artificial pneumoperitoneum also carries the risk of complications such as intra-abdominal organ damage, hypercapnia and acidosis, gas embolism, cardiac rhythm disturbances and postoperative secondary bleeding poke hernia, and must be performed under general anesthesia, which is more traumatic for the patient and increases the cost. Therefore, the conventional surgical approach is no longer able to meet the needs of patients with higher requirements for this procedure. Microsurgical high ligation is performed mostly through the inferior approach to the external inguinal ring, without dissecting the extra-abdominal oblique tendon membrane and inguinal canal, with minimal surgical trauma and avoiding damage to the inguinal nerve and inferior iliac abdominal nerve. During the operation, all the testicular reflux veins such as the internal spermatic vein, the external spermatic vein, the levator muscle vein, the vas deferens vein, and the collecting vein can be directly observed under a microscope with a 10 times magnified field of view, and the internal and external spermatic veins and the collecting vein of the testis can be cut off, resulting in the lowest recurrence rate of varicose veins after surgery. The microsurgical technique also makes it easier to accurately identify and protect the testicular artery and its branches and the levator artery and its branches (down to 0.5-1.5 mm in diameter), and the risk of postoperative testicular atrophy is almost non-existent. At the same time, lymphatic vessels, which are easily identified microscopically, can be avoided and the incidence of postoperative scrotal edema and syringomyelia can be greatly reduced. Because the small incision can be covered by scrotal hair after surgery, the aesthetic needs of the patient can be met. Currently, microligation has become the procedure of choice for the treatment of varicocele in the United States. In China, due to the constraints of stereotypes, technical level and equipment conditions, it is only carried out in a small number of large hospitals and has not yet become popular, but there is a trend of springing up.