A system for securing and manipulating a patient during a medical procedure comprises a support assembly coupled to a bed and configured to support a patient's leg. In addition the system comprises a rail coupled to the support assembly. The rail has a longitudinal axis, a first end, and a second end opposite the first end. In addition, the system comprises a perineal post movably mounted to the rail and oriented in a generally vertical direction. The post assembly is configured to move axially along the rail between a first position and a second position.