Editorial Comment for McVey et al .

This well-designed research demonstrates that better baseline performance on an advanced, but not basic, laparoscopic and robotic skill task may correlate with a shorter learning curve for basic robotic skills. This highlights and supports the need for surgeons learning robotic surgery to acquire good advanced laparoscopic skills to facilitate their robotic surgical proficiency. This holds true for both cognitive and skill task training and is the basis for the recommendation of the Basic Laparoscopic Urology Surgery curriculum on the AUA website for surgeons learning robotic surgery techniques. The principles of laparoscopic surgery form a solid platform on which robotic surgical skill can be developed. Although surgeons should have the skills to convert to a laparoscopic approach in the event of a technical robotic equipment failure, now there is evidence this learning also enhances the robotic skill training process.

Other researchers have demonstrated that general basic skill acquisition in laparoscopy can significantly improve clinical performance of more advanced laparoscopic techniques. ¹ It seems intuitive that advanced laparoscopic skill training will improve trainee acquisition of robotic surgery skills. The key is to develop expert-prescribed criteria for proficiency and ensure that trainees understand these performance parameters so they train to this level before advancing to more complex techniques. In addition, researchers have suggested that, when performing complex tasks such as knot tying, surgical robotics is most useful for inexperienced laparoscopists who experience an early and persistent enabling effect. For experts, robotics is most useful for improving economy of motion, which may have implications for the highly complex procedures in limited workspaces. ² The next step is at the multiinstitutional level to better evaluate the relationship between residents' perceived importance of the skills and their perceived future career activities and their skill performance level during training.