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It just occurred to me upon review of this that introducing my friend to needle drivers would do him a disservice rather than a favor, because the needle driver you suggested as an improvement has exactly the same problem as the hemostat I modifed for him: the finger holes are clearly too small for his big, gnarly fingers. He's a big old farmer, not a surgeon.
If a tool is to be useful it must fit both the job and the user. It's no kind of gift to the recipient if it doesn't work for him.
My friend is an old farmer and fisherman, not a surgeon doing sutures. My objective was to enable him to tie knots attaching fishing lures to 8 lb test (0.25mm) monofilament line (not sutures) with fingers that flat don't fit thru small loops and can barely feel the monofilament line. We were both pleased to see that the modified hemostats work nicely for him. He uses them. Even if needle drivers with big finger holes could be found, they wouldn't work better for him.
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Another thing I didn’t know - so is there an explanation about why the finger openings get smaller? Someone needs to tell us why
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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.
