When a transparent liquid or solid medium is present in front of an opaque target being irradiated by an intense laser beam, then the expansion of hot vapors generated (at the interface between the medium and the target) by the irradiated heating of the target is restrained by the medium. The tamping effect of the overlying liquid or solid can cause a much larger fraction of the deposited energy to go into kinetic energy, which leads to enhanced tissue disruption, compared to when a gas or vacuum is in front of the target. Condensable vapors and high thermal conductivity in the surrounding material facilitate rapid energy transport our of the vapor, which can cause a major reduction in the tamping enhancements. This contained-vaporization process is likely important in laser-medical applications such as, for example, laser angioplasty and laser lithotripsy. The work enhancement by the process is probably advantageous for lithotripsy in providing the necessary energy to break urinary stones; however, for angioplasty, the enhancement may provide little aid in removing plaque but may cause significant damage to arterial walls. If gas could be introduced into the artery preceding irradiation of the plaque, then the enhancements could be avoided. In summary, careful management of the tamping conditions during tissue irradiations in the clinical applications of lasers should lead to significant improvements in the overall desired outcome.