The role of surgical simulation and the learning curve in robot-assisted surgery.

New surgical teaching methods are continuously being developed to overcome the learning curves of new advanced surgical procedures. The learning curve is recognized in most minimally invasive and robot-assisted surgery. The development of complex skills-training models and simulators, although in its infancy, has started to facilitate the transfer of these skills to novice surgeons without increasing the risk to patients' safety. Robotic surgery, whether in the specialties of urology, general surgery, or cardiac surgery, has become the ideal platform to integrate simulators for teaching purposes. Its different interface requires the surgeon to acquire more advanced skills compared with conventional open or laparoscopic surgery. However, simulators can allow the naïve surgeon to develop these skills and pass the learning curve without the medico-legal implications of surgical training, limitations in trainee working hours, and ethical considerations of learning basic skills on humans.