Varicose veins (commonly known as “floating hamstrings”) are the most common cause of venous system disease, which is the result of many factors, mainly genetic factors, congenital dysplasia and acquired lifestyle habits, etc. Some patients also have a combination of long-term asthma and constipation, which causes long-term abdominal pressure, and some female patients mainly have increased abdominal pressure during pregnancy, which leads to the destruction of the venous valves and eventually causes varicose veins. Varicose veins occur in the legs of the lower extremities, where the skin appears red or blue like spider webs, earthworms, or hard nodules like tree tumors, and the veins become abnormally enlarged and swollen and varicose. Examination of varicose veins of lower extremities: In the medical history, it is important to ask whether there are occupational family members, good or bad relationship between pregnancy and the onset of varicose veins, whether there are chronic diseases of chest or abdomen, history of trauma to the lower extremities, whether there is deep phlebitis or deep vein thrombosis, to understand the time of occurrence and the only symptoms (heaviness of lower extremities, vague calf pain, easy fatigue, edema and bleeding), as well as to understand the relationship between the symptoms and the feeling of standing and resting in bed, and the past treatment and results. A detailed examination of the system for other diseases, the presence of intra-abdominal masses (with particular attention to the presence of pelvic tumors), the presence of pregnancy, and the presence of local vascular murmurs. Check whether the lesion is in the saphenous vein or the small saphenous vein, on one side or both sides, the degree of varicosity, whether the saphenous valve is functional, whether the deep veins are patent, and whether the valves of the interdigitating venous branches are functional by conventional methods. Examine the affected limb for edema, hyperpigmentation, ulceration, eczema, and acute inflammation. Distinguish them from varicose veins caused by arteriovenous fistulas and deep vein thrombophlebitis. Most patients with varicose veins are not critical and do not require treatment or injections, health care and prevention are the most important, but if the varicose veins are too severe, they are prone to recurrent ulcers and infections and bleeding, mainly due to misconceptions and wrong treatments, which can aggravate the symptoms of varicose veins. In general, the treatment of varicose veins in lower limbs can be done in the following three ways. (a) Non-surgical treatment: It mainly includes wearing elastic stockings or elastic bandages on the affected limbs to facilitate reflux with the help of the pressure difference between the distal side and the proximal side, so that the varicose veins are atrophied. In addition, prolonged standing and sitting should be avoided and the affected limb should be elevated intermittently. Non-surgical therapy to improve symptoms is suitable for: ① those who have limited lesions and mild symptoms and do not want to operate; ② those who develop during pregnancy and have symptoms that may disappear after delivery, so non-surgical therapy can be performed temporarily; ③ those who have obvious symptoms but have very poor tolerance for surgery. (b) Sclerotherapy and compression therapy: the inflammatory reaction caused by the injection of sclerosing agent into the varicose vein causes it to be occluded. It is suitable for small, limited lesions or as an adjunct to surgery to deal with residual varicose veins. (iii) Surgical treatment: Surgery is the most effective and fundamental treatment method. Anyone with symptoms and no contraindications (e.g., very poor surgical tolerance) should be treated surgically. Traditional surgery includes: high ligation and stripping of saphenous or small saphenous vein, superficial vein point stripping, traffic vein ligation, etc. Minimally invasive procedures include: endovenous electrocoagulation, endovenous laser therapy, endovenous radiofrequency therapy, transilluminated direct visual rotation, and subfascial endoscopic traffic branch ligation, each with its own advantages. The following is a comparison of the advantages and disadvantages of common clinical procedures: Compression therapy method: the use of elastic stockings to reduce edema during exercise by using external pressure, theoretically, the pressure of elastic stockings is greatest at the ankle and gradually decreases upward, and the pressure is usually best. If the patient has already developed leg ulcers due to venous hypertension, he or she should respect the physician’s instructions, take antibiotics and diuretics and supplement with special treatment. Sclerotherapy: A hypertonic solution (such as highly concentrated saline or sclerotherapy) is injected into the varicose vein to destroy the lining of the vessel and make it disappear after healing, but only small varicose vessels can be treated, and there may be severe pain, pigmentation, and even inflammation, redness, and ulceration during treatment, and there are recurrences, so it is only suitable for a small number of patients. Extracorporeal laser or pulsed light: The same principle as the laser cosmetic treatment to remove spots, the advantage is that only local anesthesia is needed, the treatment time is short, the pain is low, the wound is quite small, no unsightly scars will be left, and you can walk immediately, but only for the microscopic spider veins, you have to pay for it yourself, and it takes several sessions to be effective. Surgical aspiration: An incision is made in the groin to cut and ligate or aspirate the saphenous vein, which requires semi-body or general anesthesia and requires hospitalization. If the varicose veins are too severe, several small wounds may be required to remove a section of the varicose vein. Endovascular cautery treatment: A small incision is made on the inside of the knee or ankle, a very thin catheter is placed, and high frequency waves (or radiofrequency) or laser beams are used to cauterize the varicose veins to block the blood flow. Therefore, some hospitals feel that repeated use of a fiber optic has a higher chance of infection, and most patients may not be solved by this method alone, but need to be supplemented with other methods such as minimally invasive varicose vein rotation system to have a more complete treatment, and individual patients with very thick vein trunk may have incomplete vascular occlusion or thrombosis after laser treatment, requiring a second surgery. Minimally invasive endoscopic system of varicose vein rotary cut: using endoscope and suction rotary cut to crush and suck out the earthworm-like veins, the wound is smaller and more beautiful than traditional surgery, but the trauma under the skin is larger, so it can be called “small incision surgery”, but it cannot be considered “minimally invasive surgery”. It can be called “small incision surgery” but not “minimally invasive surgery” and is prone to postoperative complications such as hematoma, lymphedema, and local skin numbness.