Mixed Reality (MR) surgery has not been effectively implemented in telemedicine due to strict requirements of security and delay minimization during real-time video transmission. Hence, this paper aims to propose a novel solution for Surgical Telepresence with highly secured and faster real-time video transmission. The proposed system consists of three components: Authentication (Pre-surgery), Data transmission (During-Surgery), and Storage (Post-Surgery). For Authentication, Pass-Matrix technique is used at both ends to provide graphical passwords. During the surgery, a hybrid system is used to provide highly secured and faster real-time video transmission. This system includes a Feistel Encryption System (FES), Modified Scaled Zhongtang Chaotic System (M-SCZS), and Modified Advanced Encryption System (M-AES) algorithm. After Surgery, the transmitted data are stored using the Information Accountability Framework (IAF) for future purposes. The results are obtained from the during-surgery stage for jaw, breast, and bowel surgery. Both solutions are simulated in MATLAB on a personal computer with average processing capability. The proposed solution improves the entropy from 7.733~7.782 to 7.798–7.996 and reduces the processing time from 8.642~9.911 s/frames to 5.071~6.563 s/frames. The proposed focus on reducing the total processing time for the encryption and decryption process with improving security during the surgery process. Finally, this solution provides a fast security system for surgical telepresence that helps both local and remote surgeons for secure real-time communication. The complexity for this work need to know the used chaotic method, the values of the chaotic parameters and for which this method was used, in addition to the complexity of state of the art.