Enabling collaborative telepresence in healthcare, especially surgical procedures, presents a critical challenge. The decompressive craniotomy procedure stands out as particularly complex and time-sensitive. The current teleconsultation approach relies on 2D color cameras, often offering only a fixed view and limited visual capabilities between experts and surgeons. However, teleconsultation can be addressed with Mixed Reality and immersive technology to potentially enable a better consultation of the procedure. We conducted an extensive user study focusing on decompressive craniotomy to investigate the advantages and challenges of our 3D teleconsultation system compared to a 2D video-based consultation system. Our 3D teleconsultation system leverages real-time 3D reconstruction of the patient and environment to empower experts to provide guidance and create virtual 3D annotations. The study utilized 3D-printed head models to perform a lifelike surgical intervention. It involved 14 medical residents and demonstrated an in-vitro 17% improvement in accurately describing the incision size on the patient’s head, contributing to potentially improved patient outcomes.