The main objective of this project is to develop a completely new type of laser system, which will pave the way for significant advances in a variety of clinical applications that encompass minimally invasive procedures, surgeries and endoscopies. Currently, the application of medical lasers is starkly limited by the lack of flexibility and versatility of most commercial laser systems. These systems typically emit light at a single, fixed wavelength which renders each laser suitable for a very narrow range of applications. For example, the removal of tissue via ablation requires a wavelength in the infrared spectral region, typically between 2000 and 3000 nm. The exact wavelength that is optimal for a given surgical task depends on the structural properties and water content of the tissue, Thus, having the ability to tune the wavelength across a large spectral range to optimize the incision parameters (i.e. ablation profile, collateral cell damage etc.) would be highly beneficial. In addition, to maintain good visualization during any operation is key for the effectiveness and the outcome of the procedure. Control of homeostasis and coagulation can be achieved through laser light as well, however, in a different wavelength range than ablation. Our instrument will provide a simultaneous dual wavelengths output which allows tissue cutting and the control of wound bleeding at the same time. This proposal will focus on the assembly, testing and clinical characterization of the new table-top laser instrument. Due to its all-solid-state construction, the laser instrument will be very robust, reliable, compact and portable. Glass fiber optics will be used to deliver the power to a pen-size hand piece that enables flexible delivery of the laser output to the target tissue with high-precision and unprecedented control. Alternatively, the laser power can be delivered through an endoscope (or laparoscope) to both cut and control bleeding in confined spaces. It is our vision that procedures currently being done with more traditional surgical access, may be converted to minimal access. This is especially the case where wide exposure is retained principally for the control of hemorrhage. This concern would be alleviated by the flexibility of this new laser tool. Minimal access improves patient outcomes by reducing the morbidity and complications of brain manipulation. PUBLIC HEALTH RELEVANCE (provided by applicant): The aim of this research is to design a new laser instrument for advanced medical procedures, which involve any type of tissue removal and subsequent control of wound bleeding. By combining the advantages of multiple lasers in a single compact device, surgeons and endoscopists will have the opportunity to make very precise excisions in a large variety of different tissues while simultaneously controlling wound bleeding.