Research on collaborative virtual surgery opens the opportunity for simulating the cooperative work during surgical operations. It is however a challenging task to design and implement a high performance collaborative surgical simulation system because of the difficulty in maintaining a high level of state consistency under limited network transmission capacity. In this paper, we present an adaptive framework using cluster-based hybrid architecture to support real-time collaboration in surgical simulation. In addition to the TCP communication protocol, the framework is also equipped with UDP for multicasting, allowing for a flexible strategy to reduce network latency. A set of techniques was proposed to assure reliable transmission on top of standard yet unreliable multicast protocols. Experimental results demonstrate that this framework can support collaborative surgical simulation with lower network latencies than traditional client-server architecture.