That doesn't look all that large for a piece of medical equipment. The old ruby and gas laser based units were significantly larger. People forget how big and bulky lasers were prior to the diode laser revolution over the last 20 years or so, and even with small diode lasers there is a whole lot of other stuff in there. Optics, computer control, safety systems and interlocks, power supplies, cooling, etc. Medical equipment is a different world.