A system for facilitating access through a substantially planar and laterally oriented patient skin surface includes a guiding substrate extending substantially parallel to the skin surface and selectively directly fastened thereto. The guiding substrate supports a guiding structure in a substantially fixed relationship to an access site of the skin surface. A tool carriage is configured to accept surgical tools for sequential interaction with the access site. The tool carriage engages the guiding structure such that the tool carriage is guided along a predetermined action path when motive force is provided to the tool carriage. The tool carriage is guided along the action path with an incising tool in penetrating contact with the access site of the skin surface to create a laterally elongate incision at the access site. The tool carriage is guided along the action path to substantially close the incision at the access site.