I can explain it. I am a plastic and reconstructive microsurgeon with 25 yrs experience. While people with smaller hands do gravitate to smaller instruments (usually women) those of us with larger hands “palm” the instruments. I cannot tell you the last time I actually put my fingers through a needle driver or haemostat. (Although if they had bigger handles like those I might.) By keeping the instrument in your palm you have more control of the tip and a greater range of motion than you get just from your wrist and thumb. You can release them more easily by using your thenar eminence (the meaty bulge at the base of your thumb).
Just as a practical FYI: Needle drivers are usually straight and have a finer toothed carbide jaw (better grip and wears better). Haemostats have a bit larger teeth and can be straight or curved. The Tonsil or Adson Haemostat tend to be longer reach and a finer tip. I find them invaluable in the shop. Hope that helps.

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