Devices for guiding an instrument into a body of a patient, at a targeted point of entry and along an insertion path at a targeted insertion angle, are described herein, such as a guide for an access needle in a PCNL procedure for accessing the kidney to remove kidney stones, the devices comprising a base component, a guide assembly, and optionally an insertion mechanism. The base component is aligned in use with the point of entry and the guide assembly cooperates with the base component to allow for the instrument to be aligned and fixed at any circumferential angle around an axis perpendicular to the point of entry and at any vertical angle ranging from 0 to 45 degrees away from the axis in a direction toward the body. The optional mechanism allows for mechanical insertion once the instrument is aligned and fixed. Devices and methods disclosed herein allow a medical professional to accurately and stably guide an instrument at a targeted point and angle and to a desired depth, while minimizing the exposure to radiation in the surgical field that is used to image the insertion path.