A surgical trajectory alignment device is disclosed, including an alignment trajectory guide holding portion shaped to receive and secure an alignment trajectory guide along a longitudinal patient entry axis, the longitudinal patient entry axis falling within a plane. The surgical trajectory alignment device further includes a first alignment trajectory guide holding portion activator operable to rotate an alignment trajectory guide secured by an alignment arm holding portion within the plane; and a second alignment trajectory guide holding portion activator operable to translate an alignment trajectory guide secured by the alignment arm holding portion in a direction away from the plane.