It is now well known and accepted that the thymus plays a central role in the pathogenesis of autoimmune nonthymomatous and thymomatous myasthenia gravis (MG) [1, 2, 3, 4, 5]. While in case of a thymoma oncological reasons make surgery mandatory and the sternotomy route is the golden standard, on the other hand the presence of a radiologically “normal” thymus makes the choices of the thymectomy and of its surgical approach more controversial [6, 7, 8, 9, 10, 11, 12]. From retrospective studies it is quite evident that all thymectomies are not equal both in extent of thymic tissue removed and in neurological results [5]. Briefly it can be stated that the more complete the thymectomy the better the results [5]; on the contrary, it is sufficient to leave behind 2 g of residual thymus to reduce the therapeutic value of the thymectomy and produce a lower remission rate [13].