Preoperative preparation The perineum and affected limbs were prepared, shaved and the skin cleaned. The main trunk of the saphenous vein and the direction of the varicose vein should be marked with methyl violet and iodine 1h before surgery. One 810nm 30W semiconductor laser, one bare fiber with 600μm core diameter and 750μm outer diameter, one 5F straight tip angiographic catheter, one 0.035″ 150cm long hydrophilic guidewire, two 18-gauge puncture needles, and several self-adhesive elastic bandages were prepared. Fiber introduction The saphenous vein is punctured with a trocar needle in front of the patient’s inner ankle, a hydrophilic guidewire is placed through the trocar, and a contrast catheter is placed through the guidewire to below the inguinal ligament. The guide wire is removed and the laser fiber is inserted through the catheter, and the red spot of the fiber can be seen moving subcutaneously under the inguinal ligament. Needle hole high ligation A 0.2 mm puncture hole is made 3 cm below the inguinal ligament, centered on the light spot, on both sides of the saphenous vein. The needle is entered from the puncture point on one side, and a double 7-gauge suture is drawn through between the saphenous vein and the superficial femoral vein, and the needle is exited from the puncture point on the other side. Then the suture is fed through the original exit needle hole, the risk passes between the saphenous vein and the skin, the needle is exited from the original entry needle hole, the suture is pulled tightly to detect whether the fiber can pass through, it cannot pass through indicating that the saphenous vein ligation is satisfactory, the risk can be ligated, the thread is buried under the skin with mosquito hemostatic forceps to complete the high ligation, there are only two pinhole size traces at the root of the thigh, there is no incision and no need to remove the thread. The depth of needle entry should be mastered during the operation to avoid damaging, or suturing, the superficial femoral vein. Saphenous vein trunk coagulation treatment Turn on the laser pulse, slowly retract the fiber, and coagulate the saphenous vein from top to bottom at a frequency of one pulse every 0.5 to 1.0 cm, while the assistant presses the saphenous vein with the light spot. The laser power is 15~l8 w above the knee, 1S every 0.5~1cm of blood vessel with 1S interval. l2 w below the knee, 1S every 0.5~1cm of blood vessel with 1S interval. for those with severe varicose varices in the middle saphenous vein or combined with local stenosis where the cannula cannot pass, the saphenous vein can be punctured on the medial side of the knee and the coagulation catheter and fiber can be inserted upward from the saphenous vein here. This operation was performed in 17 cases in this group. Coagulation of varicose vein masses For obviously tortuous and dilated, short and shallow lateral branches of the saphenous vein, a 16-gauge trocar needle is used to puncture the varicose vein, the laser fiber is inserted through the trocar lumen, the trocar is retracted, and the varicose vein and the subcutaneous tissue surrounding the vein are laser coagulated. For severe varicose vein masses, local suture ligation with cotton pad fixation is feasible, and percutaneous suture ligation is feasible for both medial calf traffic branch veins.