A surgical underlay pad to secure a patient's torso while in a Trendelenburg position, the pad comprised of a flexible substrate with an adhesive gel coat on one or more sides of the substrate having a shear strength such that when the pad is positioned on an operating table surface and the table is tilted, the pad and the torso positioned on the pad resist sliding. The gel coat can be applied as a continuous coating or in a variety of patterns. The pad is removable and the gel coat forms a water resistant bond with the operating table surface. The gel coat reduces the overall mass of the pad, and is cost effective, easier to manufacture, and produces less environmental waste.