Varicose veins in the lower extremities are common clinical diseases, most patients only show worm-like elevation of the superficial veins in the lower extremities without other clinical manifestations. When the disease progresses to a certain degree, complications such as lower extremity edema, itching, intravenous thrombosis, sterile inflammation (phlebitis, hyperpigmentation, ulceration, bruising dermatitis, rupture bleeding, etc. can also occur, and they do not heal for a long time and become more and more serious. Should I have surgery for varicose veins? What is the best time for surgery? What is the best surgical procedure to take? Will there be any recurrence after the surgery? Are there any complications of surgery? These questions often bother patients and their families, and professional doctors are reluctant to give positive and direct advice to patients because of the current tension between doctors and patients, leaving patients to choose the timing of surgery and treatment methods on their own. Prevalence, pathogenesis and etiology Depending on race, gender and region the prevalence of varicose veins in the lower extremities in the population is about 5-25% left patients right, its occurrence is closely related to genetics, work habits, general health condition and so on, it has been a multifactorial and multi-stage disease. Venous hypertension is the most important pathogenesis of varicose veins in the lower extremities, while valve regurgitation, deep venous outflow tract obstruction and calf muscle pump dysfunction are the most common causes of the formation of lower extremity venous hypertension. Currently, most scholars believe that valvular regurgitation plays a dominant role in the formation of venous hypertension. Valve regurgitation that occurs at the intersection of superficial and deep veins, such as the saphenofemoral and saphenous N veins, can cause an increase in pressure in the superficial veins, leading to varicose veins that develop from the top down. Regurgitation of the valves in the communicating veins, on the other hand, allows the pressure of the deep venous blood flow and the pressure generated by the calf muscle pump during exercise to be transmitted backwards into the superficial veins, causing an increase in venous pressure after exercise and at rest, resulting in varicose veins that develop from the bottom up. Primary venous valve insufficiency manifests as weakness of the vein walls and valve leaflets that cannot withstand the pressure of venous blood flow, and the cause of its formation remains unclear. Timing of Surgery The vast majority of patients with asymptomatic varicose veins or elderly patients are treated conservatively, including medications or compression stockings. This choice is justified based on the consideration of surgical trauma, economic burden, and the risk of surgery at the patient’s advanced age. However, medical development today, the answer to the question of whether “early surgery or conservative treatment is better for varicose veins first?” The answer to this question has gradually changed. More and more varicose vein patients are opting for early minimally invasive surgical treatment. First of all, drugs and compression stockings, as the main means of conservative treatment for varicose veins, can only delay the development of the disease but not treat the root cause of varicose veins. Therefore, drugs can only be used as an adjunctive treatment after varicose vein surgery in the lower extremities. Although the effect of elastic stockings is exact, they need to be worn for life, and they are troublesome and expensive to use. At present, the vast majority of patients who initially wear compression stockings eventually opt for surgery. So. Since surgery is required in the end, the time and effort spent on conservative treatment is wasted. Overall, the pain and inconvenience of long-term disease has far outweighed the pain and minor complications of minimally invasive surgery. Advances in medicine have also led to increasingly minimally invasive surgery for varicose veins in the lower extremities, and the adoption of minimally invasive surgery has shortened the time that used to require a two-week hospital stay to just within 3-5, or even the ability to operate in a day ward and then go home the same day. The choice of surgical procedure Endovenous Laser Closure (EVLT) is a procedure that uses a special wavelength (810-980nm) laser to intervene through fiber optics to the main trunk and branches of the saphenous vein and then to close the vein, a technique that to some extent avoids some of the complications associated with aspiration of the saphenous vein. For example, scarring, hematoma, saphenous nerve damage, etc. Other techniques with similar treatment principles as the laser are: radiofrequency closure and microwave thermal coagulation. All 3 techniques have in common the avoidance of saphenous vein aspiration. However, for excessive varicose vein masses, a combination of traditional stripping procedures is often necessary. The high recurrence rate of laser treatment in clinical practice occurs mainly in cases of inexperienced surgeons and excessive saphenous vein caliber. In addition, discomfort due to striae phlebitis in the thighs one week after laser treatment is one of the complaints of many patients. The Trivex technique, designed for patients with extensive varicose veins in the lower leg, uses a subcutaneous light source to locate the varicose veins, which are then removed using a trivex system. 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 applicable to the trunk of the great 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. Sclerotherapy injections require no anesthesia, no incisions, and are inexpensive. But there are many problems. The main sclerosing agents include sodium cod liver oil acid and polyglactin. However, there are great risks associated with sclerotherapy injections; one is that skin necrosis can result if the sclerosing agent injection fluid leaks out. Second, once the sclerosing agent flows into the deep vein, it can lead to thrombosis and, in severe cases, pulmonary embolism. In recent years, the international sclerosing agent injection has made a series of improvements, such as: the emergence of microfoam technology (microfoam), which can make the occlusion effect better while reducing the concentration and dosage of sclerosing agent, greatly avoiding the past complications. However, sclerotherapy injections are very ineffective in the management of the saphenous vein trunk. The high recurrence rate in clinical practice and the factors of the domestic medical environment make it not widely used. Some small medical institutions package sclerosing agent injection as “the latest therapy”, “thrombolysis”, “interventional ablation”, etc., which is somewhat deceptive.