Proximal gastric pouch dilatation (PPD) or enlargement is the most common cause for revision surgery, and a leading cause of band intolerance and failure following laparoscopic adjustable gastric band surgery. We have recently reported some interesting, unexpected, and clinically important factors associated with the development of PPD in 3,000 consecutive cases of primary laparoscopic adjustable gastric banding (LAGB) procedures. These associations were clear and highly statistically significant, but not perceived by the bariatric team managing these patients. Is this a case of inattentional blindness in clinical practice? Inattentional blindness is the failure to recognize a visual stimulus that is present within your visual field. This phenomenon becomes more apparent when higher levels of concentration are required to complete a task as attention is focussed on the task itself rather than on unexpected findings or alternative explanations.