Abstract This manuscript describes a rare and clinically significant case of a prolapsed vitellointestinal duct (VID) in a 6‑week old‑old infant, successfully managed using a scarless trans‑umbilical wedge resection performed entirely under local anesthesia. While VID anomalies are well documented, the use of a minimally invasive, awake surgical approach in an infant is exceptionally uncommon. Our report highlights a safe and effective alternative to general anesthesia in selected infants, a cosmetically superior trans‑umbilical technique, a rapid postoperative recovery with same‑day discharge and practical, reproducible method that may benefit centers with limited access to pediatric anesthesia Trans‑umbilical natural orifice surgery (e.g., trans‑umbilical wedge resection, umbilical hernia repair, laparoscopic umbilical port entry) relies heavily on effective somatic analgesia of the periumbilical region. The rectus sheath block (RSB) is uniquely suited for this because it targets the anterior cutaneous branches of T9–T11, which supply the umbilical area.