Objective To evaluate the clinical effectiveness of the lateral single-incision laparoscopic totally visceral sac separation technique (L-SILTVS) in the repair of umbilical hernia. Methods A retrospective analysis was conducted on 28 patients with umbilical hernia who underwent L-SILTVS between June 2023 and December 2025 at the First Affiliated Hospital of Ningbo University, Ningbo Beilun Traditional Chinese Medicine Hospital. Intraoperative peritoneal quality, operation time and postoperative pain, complications were observed and recorded. Results Among the 28 patients, the procedure was successfully completed in 27 cases, with 1 case requiring a modification in the operative approach; no conversion to open surgery occurred. The mean age was (54.3±15.9) years, and the mean body mass index was 29.4±4.4. The median operative time was 64 (54, 93) minutes, and the median blood loss was (3.6±2.7) mL. Three distinct peritoneal types were identified: intact(17 cases), attenuated(10 cases), and friable(1 cases). Intraoperative peritoneal rupture occurred in 20 cases（71.4%）, and no rupture in 8 cases（28.6%）.Postoperative visual analog scale pain scores at 6, 24, and 48 hours were (3.0±0.6), (2.0±0.6), and (1.0±0.4)points, respectively. The mean postoperative hospital stay was (2.9±0.6) days. Patients were followed up for 7 (1-30) months postoperatively, and no surgery-related complications were observed. Conclusion L-SILTVS demonstrates favorable short-term outcomes in specific umbilical hernia patients with appropriate indications. However, the procedure is technically demanding, highlighting the importance of meticulous surgical details, peritoneal status evaluation, and cautious implementation.