A pad assembly, system and method of securing a patient onto an operating table when the patient is in the Trendelenburg position. The pad assembly and system is used to support and hold a patient on a medical procedure table during a medical procedure performed while the table, and thus the patient lying thereon, is in an inclined position, such as the Trendelenburg position. The pad assembly and system has characteristics which promote improved securing to eliminate shifting and/or sliding due to gravitational forces when the patient's body is in the Trendelenburg position, as well as promote a secure holding of the patient in a desired position on the table, in order to minimize injury to the patient. The pad assembly and system further has improved channels to allow for drainage of fluids that may otherwise be trapped between the patient's body and the OR Table during the surgical procedure.