Procedure GSV is punctured at the knee with a needle of 16–18G in the Trendelenburg position, followed by the intro­duction of vascular sheath. Laser bre is introduced through vascular sheath and is advanced up to 2cm caudal to the saphenofemoral junction and is conrmed with sonography followed by tumescent anaesthesia administration (Fig. 27.3). Laser is then red and supercial vein is ablated with slow withdrawal of the laser bre. The withdrawal rate of laser bres in continuous mode is 2–4mm/sec and is stepwise at 10–15W power if red in pulsed mode. It has been found that the pulsed mode leads to more complications than the con­tinuous mode, so the continuous mode is usually preferred over the pulsed mode [8]. There are laser bres of different wavelengths available ranging from 810 to 1920 nm. Laser bres of lower wavelength use haemoglobin as chromophore, and water is used as chromophore in higher wavelength laser bres. 1470nm wavelength laser bres are most commonly used nowadays. It has been found that higher wavelength laser bres are more efcient in energy transmission and result in high occlusion rate. Higher wavelength laser bres lead to less post-operative complications like pain and skin discolouration [9]. After the procedure, patients are told to use compression bandages and advised to do their daily activ­ities immediately. A follow-up sonogram is done 24h after the procedure to assess and conrm the ablation of the super­cial vein and rule out deep vein thrombosis(Fig. 27.4).