There are two seperate variables: the needle holders angle, & the spot on the needle grasped by the holder. This needle can be perpendicular, acute, parallel or obtuse to the holder's axis. When you have the needle placed perpendicular to the needle holder, the needle can be driven through tissue by merely rotating the holder on its axis; a manipulation that requires no additional space. If, instead the needle is put at an oblique or obtuse angle next to the needle holder, If you want the needle to advance through the tissue, then the handles must follow a wide arc through the curve. Unfortunately, in difficult access areas like when you get tempted to use a non-perpendicular needle to direct the needle, there is less space to move the needle holder handles through the necessary arc. In a few cases, Its so much more easy to use a perpendicular needle to the correct way than having to struggle with maneuvering the needle handles into a wide arc to power an acute or obtuse angle through the tissue. A few instances occur when placing a the needle through the tissue. Few situations exist where there is an advantage in placing the needle at an obtuse or an acute angle to the needle holder. The more professionol the surgeon is with there surgical instruments, the less his need for curved needle holders & weird needle positions.
A differnet way of the needle is the plane of it curved parallel to the handle, "hooking" down in a deep wound you must sew layers parallel to the surface. Doing it like this gives ease to the point & needs a quick moving back & forth for the needle through the tissue. Such a maneuver uses very minimal or no space in handle manipulation, in comparasion to oblique attitudes.
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