Application of case-based learning combined with three-dimensional image reconstruction technology in the skill teaching of laparoscopic partial nephrectomy

doi:10.3760/cma.j.cn115259-20250830-01030

Abstract

Abstract: Objective To explore the application effect of case-based learning (CBL) combined with three-dimensional (3D) imaging reconstruction technology in the teaching of laparoscopic partial nephrectomy, and to provide empirical evidence for optimizing the training program for this surgical procedure. Methods A total of 59 visiting physicians from the Department of Urology at The First Affiliated Hospital of Zhengzhou University from January 2024 to June 2025 were selected as the study subjects. They were divided into a experimental group (28) and a control group (31) according to the chronological order of their training. The experimental group received CBL combined with 3D imaging reconstruction teaching, while the control group received traditional teaching using slides and surgical videos. Teaching effectiveness was evaluated through theoretical assessments, case analyses, and a course satisfaction questionnaire. Data were analyzed using t-tests and Chi-square tests. Results The experimental group showed higher theoretical assessment scores [(88.32±5.66) points] and excellence rate in case analysis [75.0% (21/28)] compared to the control group [(81.29±7.22) points, 22.6% (7/31)], both P<0.01. Regarding course satisfaction, the ″very satisfied″ rates in the experimental group for the three dimensions of ″course rationality″, ″content practicality″, and ″comprehensive evaluation″ were 71.4% (20/28), 64.3% (18/28), and 78.6% (22/28), respectively. These rates were higher than those in the control group [25.8% (8/31), 16.1% (5/31), and 38.7% (12/31)], all P<0.01. Conclusions CBL combined with 3D imaging reconstruction technology can enhance the teaching effectiveness of laparoscopic partial nephrectomy through the synergy between anatomical visualization and the cultivation of clinical thinking. It is recommended as a preferred training program for promotion.

Key words: Urology, Laparoscopic partial nephrectomy, Case-based learning, Three-dimensional image reconstruction, Skill teaching

CLC Number:

R-05

Li Peng, Dong Biao, Zhang Erwei, Liu Xu, Xing Jiawei, Zou Hailiang, Liu Hang, Gu Yue. Application of case-based learning combined with three-dimensional image reconstruction technology in the skill teaching of laparoscopic partial nephrectomy[J]. Chinese Journal of Medical Education, 2026, 46(6): 438-442.

References

[1] Bex A, Ghanem YA, Albiges L, et al. European Association of Urology Guidelines on Renal Cell Carcinoma: the 2025 update[J]. Eur Urol, 2025,87(6):683-696. DOI: 10.1016/j.eururo.2025.02.020.
[2] 黄健,张旭. 中国泌尿外科和男科疾病诊断治疗指南:2022版[M]. 北京: 科学出版社, 2022:6-7.
[3] 中国医促会泌尿健康促进分会,中国研究型医院学会泌尿外科学专业委员会. 肾部分切除术安全共识[J]. 现代泌尿外科杂志, 2020, 25(6): 474-481,500. DOI:10.3969/j.issn.1009-8291.2020.06.003.
[4] 中国抗癌协会泌尿男生殖系肿瘤专业委员会微创学组. 中国肾肿瘤腹腔镜及机器人肾部分切除术专家共识[J]. 泌尿外科杂志(电子版), 2021, 13(4): 1-5,9. DOI:10.3969/j.issn.1674-7410.2021.04.001.
[5] 蓝建华,杜建辉,黄国华,等. 文献报告会联合CBL-PBL教学法在泌尿外科临床教学中的应用[J]. 中国继续医学教育, 2025, 17(3): 57-61. DOI: 10.3969/j.issn.1674-9308.2025.03.012.
[6] Hevia V, García-Rojo E, Brime-Menéndez R, et al. Three-dimensional virtual models in robot assisted partial nephrectomy: a needed tool in the era of precision surgery[J]. Curr Urol Rep, 2025,26(1):60. DOI: 10.1007/s11934-025-01288-y.
[7] 张淼,武文斌,杨敦鹏,等. CT三维重建肺血管支气管辅助单孔胸腔镜肺叶切除术的学习曲线分析[J]. 中华解剖与临床杂志, 2020, 25(4): 393-400. DOI: 10.3760/cma.j.cn101202-20190211-00050.
[8] 吴昊钧,汪大刚,梁梦萍,等. 结合术前三维重建的腹腔镜肝切除术学习曲线研究[J]. 肝胆胰外科杂志, 2022, 34(9): 537-542. DOI:10.11952/j.issn.1007-1954.2022.09.005.
[9] 李根,余雨豪,范雪行,等. 基于解剖特征预测肾肿瘤手术难度、并发症及预后——肾肿瘤评分系统的研究进展[J]. 现代泌尿外科杂志, 2025, 30(4): 355–363. DOI:10.3969/ji.ssn.1009-8291.2025.04.016.
[10] Grosso AA, Salamone V, Di Maida F, et al. Robot-assisted partial nephrectomy for renal cell carcinoma: a narrative review of different clinical scenarios[J]. Asian J Urol, 2025,12(2):210-216. DOI: 10.1016/j.ajur.2024.09.010.
[11] Piramide F, Kowalewski KF, Cacciamani G, et al. Three-dimensional model-assisted minimally invasive partial nephrectomy: a systematic review with meta-analysis of comparative studies[J]. Eur Urol Oncol, 2022,5(6):640-650. DOI: 10.1016/j.euo.2022.09.003.
[12] 李霖,潘秀武,崔心刚. 肾门肿瘤的腹腔镜手术难点和技巧改进[J]. 临床外科杂志, 2021, 29(2): 195-198. DOI: 10.3969 /j.issn.1005-6483.2021.02.031.
[13] 马琳,纪志刚. 从传统手术教学到泌尿外科手术技能三阶段培训体系的建立[J]. 国际外科学杂志, 2021, 48(9): 583-586. DOI: 10.3760/cma.j.cn115396-20210915-00365.

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