In some cases with movable kidneys especially in women, we need to fix the kidney to make a proper puncture.
Please look at the guidewire which goes through the percutaneous tract in flank area, ureter, bladder, and urethra. The both tips of the guidewire was fixed to the surgical drape.
After fixing the kidney with this 'through-and-through' technique, I made another puncture for scope insertion. It works very well.