An endoscopic laser scalpel system, comprising: a laser source configured to provide laser light for at least one of incision, excision, and ablation of tissue in minimally invasive surgery; and a laryngoscope or endoscope having a distal end configured to be inserted into a body cavity to deliver the laser light to a target tissue therein, an endoscopic head mounted on the distal end of the laryngoscope or endoscope, the endoscopic head comprising: an expansion negative lens positioned to expand the laser light from the laser source; a focusing positive lens interfacing the endoscopic head to the body cavity; and at least two rotatable optical elements (915, 960) positioned between the expansion lens and the focusing lens, each of which comprises an optical wedge or prism configured to refract light or a diffraction grating configured to diffract light, wherein the rotatable optical elements and the lenses are aligned with their centers on a common optical axis, and each of the optical elements is configured to rotate about the optical axis, and wherein the endoscopic head further comprises: at least two actuating arrangements each configured to rotate a respective optical element around the optical axis, each actuating arrangement comprising an electro-optomechanical unit; and a fiberscope and/or other endoscopic imaging device configured to provide or facilitate illumination of the tissue in the body cavity and to relay a live video image to an external video processor and image display. a laser source configured to provide laser light for at least one of incision, excision, and ablation of tissue in minimally invasive surgery; and a laryngoscope or endoscope having a distal end configured to be inserted into a body cavity to deliver the laser light to a target tissue therein, an endoscopic head mounted on the distal end of the laryngoscope or endoscope, the endoscopic head comprising: an expansion negative lens positioned to expand the laser light from the laser source; a focusing positive lens interfacing the endoscopic head to the body cavity; and at least two rotatable optical elements (915, 960) positioned between the expansion lens and the focusing lens, each of which comprises an optical wedge or prism configured to refract light or a diffraction grating configured to diffract light, an expansion negative lens positioned to expand the laser light from the laser source; a focusing positive lens interfacing the endoscopic head to the body cavity; and at least two rotatable optical elements (915, 960) positioned between the expansion lens and the focusing lens, each of which comprises an optical wedge or prism configured to refract light or a diffraction grating configured to diffract light, wherein the rotatable optical elements and the lenses are aligned with their centers on a common optical axis, and each of the optical elements is configured to rotate about the optical axis, and wherein the endoscopic head further comprises: at least two actuating arrangements each configured to rotate a respective optical element around the optical axis, each actuating arrangement comprising an electro-optomechanical unit; and a fiberscope and/or other endoscopic imaging device configured to provide or facilitate illumination of the tissue in the body cavity and to relay a live video image to an external video processor and image display. at least two actuating arrangements each configured to rotate a respective optical element around the optical axis, each actuating arrangement comprising an electro-optomechanical unit; and a fiberscope and/or other endoscopic imaging device configured to provide or facilitate illumination of the tissue in the body cavity and to relay a live video image to an external video processor and image display.