This document provides instructions for using a modular Trendelenburg pad system. The instructions include: placing the pad foam side up on the surgical table, positioning the pad under the patient's torso before they move to the table, ensuring the patient's perineal area is at the lower edge of the pad, using handles to lift and position the patient in lithotomy position with assistance holding the feet, and securing the patient's arms and chest with straps to minimize pressure injuries and optimize sliding during Trendelenburg positioning. Safety guidelines are also provided.