Nowadays, distributed collaborative virtual environments are used in many scenarios such as tele-surgery, gaming, and industrial training, However several challenging issues remain to be resolved before haptic virtual reality based class of applications become a common place. In this paper, we focus upon a tracheotomy tele-surgery application that is based on closely coupled and highly synchronized haptic tasks that require a high- level of coordination among the participants. We also propose a hybrid protocol that is able to satisfy all the collaborative and haptic virtual environment requirements in general and tracheotomy tele-surgery in particular. We discuss our C-HAVE tracheotomy tele-surgery framework and report on the performance results we have obtained to evaluate our protocol using an extensive set of experiments.