Training in robotic surgery: simulators, surgery, and credentialing.

The use of robot-assisted laparoscopic surgery has increased rapidly and with it, the need to better define a structured curriculum and credentialing process. Numerous efforts have been made by surgical societies to define the requisite skills for robotic surgeons, but individual institutions have the responsibility for granting privileges. Recently, efforts have focused on creating a standardized curriculum with competency-based assessments. A competency-based approach offers a better hope of honoring the principle of "above all, do no harm" and obtaining continued acceptance of new operative technologies such as robot-assisted surgery.