This systematic review reveals significant inconsistencies in cost reporting for robot-assisted colorectal surgery trials compared to laparoscopic approaches, with substantial implications for decision-making.

• Only 46.7% of the trials reported any cost data, and just 13.3% conducted formal economic evaluations.
• Robot-assisted surgery was consistently more expensive, but the evidence quality varied, with formal evaluations leading to contradictory conclusions.

Surgeons should be cautious interpreting cost-effectiveness claims of robot-assisted procedures, given the lack of rigorous economic reporting standards and potential conflicts of interest in many studies.