Lumbar hernia is a rare condition, and considerable controversy remains regarding its optimal surgical management. This study aimed to evaluate the feasibility and clinical outcomes of single-incision laparoscopic totally extraperitoneal sublay (SIL-TES) mesh repair for the treatment of lumbar hernia.

A retrospective analysis was conducted on the clinical data of 22 patients with lumbar hernia who underwent SIL-TES mesh repair between April 2020 and August 2024 at four hospitals: the First Affiliated Hospital of Ningbo University, Shanghai First People's Hospital, Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and Shanghai East Hospital. The surgical technique and procedural details were described. Perioperative outcomes, postoperative complications, patient satisfaction, and quality of life were evaluated. Quality of life was assessed preoperatively and at 1 week, 1 month, 6 months, and 1 year postoperatively using the Carolina Comfort Scale (CCS), including domains of foreign-body sensation, pain, and movement limitation.

The median operative time was 97.50 (67.75, 110.00) minutes. No conversion to open surgery or severe intraoperative complications occurred. The follow-up duration ranged from 3 to 54 months, with a median follow-up of 21.00 (10.75, 46.25) months. No hernia recurrence or surgical-site infection was observed. Comparisons of CCS domain scores and total scores at different follow-up time points showed statistically significant differences (foreign-body sensation: F=6.62, P=0.013; pain: F=62.88, P<0.001; movement limitation: F=19.52, P<0.001; total score: F=36.30, P<0.001), with all scores demonstrating significant and sustained improvement over time. The mean patient satisfaction score was (4.58±0.58), and the mean cosmetic satisfaction score was (9.29±0.91), indicating high overall satisfaction.

SIL-TES mesh repair is a safe and effective minimally invasive option for the treatment of lumbar hernia, with satisfactory short-term outcomes. By combining direct visualization with coordinated hand–eye manipulation, this technique provides a reliable therapeutic alternative. Further studies are required to evaluate its long-term outcomes.