A lithotripsy or other medical laser treatment system can include a lateral actuator to laterally displace a distal portion of a laser fiber, such as can be scanned or otherwise controlled to generate a spatial or spatiotemporal sub-targeting pattern without requiring laterally moving an endoscope carrying the laser fiber in a longitudinal passage such as a working channel. A targeted stone can be selectively weakened along the pattern, such as using lower energy pulses, before being fragmented, such as by a higher energy shock pulse.

A method of dermocosmetic treatment for skin tissue includes a plurality of treatment laser light sources which are in communication with a rectangular-shaped optical fiber; the optical fiber includes a proximal end to receive laser light from the plurality of treatment laser light sources and a distal end to transmit overlapping laser light to the area of skin tissue to be treated; the plurality of treatment of laser light sources are activated to impinge one or more rectangular-shaped laser light images within one or more rectangular-shaped areas.

Apparatus and techniques described herein can include delivery of a surgical laser beam for tissue excision or to facilitate hemostasis. The surgical laser beam can be generated, for example, using an ultrafast laser source. Such an approach can provide non-invasive treatment in relation to, for example, aerodigestive anatomy, such as for treatment of laryngeal, oropharyngeal, bronchial, and oral cavity tissues. Other generally available laser sources and their associated treatments may present various drawbacks making them less suitable for treatment for laryngeal, pharyngeal or bronchial pathologies, and use of the apparatus and techniques described herein can address such drawbacks.