Systems, devices, and methods for removing areas of tissue are described. A programmable laser may remove precise areas of tissue while the tissue remains substantially frozen. The laser is programmed in part by analyzing a reference image of a representative tissue section. A software program may receive digital images of test slices. Areas of interest in the image may be selected by a user. The software program can then create and send cut instructions to the programmable laser. The laser may be configured to make perforated cuts to remove the area of interest without melting the removed section.