I prepare my Sicilain Grandma's sauce in a cauldron. I form my meatballs as close to the same size as possible by using an ice cream scoop, then drop them into the sauce raw, to simmer and cook through for 45 minutes. Because I use shredded bread, not bread crumbs, the meatballs will increase in size by up to 50% from simmering in the sauce.
I cook the maccheroni, any amount, any shape, usually Ronzoni brand, for 12 minutes, no more, no less. Barilla is designed to remain al dente, even if you boil it for an hour! Then I dump the maccheroni into the sculapasta, shake vigorously, then dump it back into the pot. For hollow maccheroni I repeat the draining process once more. Then I add sauce to the maccheroni, just enough to coat it, and mix. Then I serve it. I don't give a tinker's damn what anyone says, the water the maccheroni was cooked in is still water, regardless of how much starch it retains, and it is not going to thicken your sauce. IT IS GOING TO WATER IT DOWN! That is an old, NONITALIAN, wives tale, like twisting your spaghetti onto your fork using a tablespoon.
This basic spaghetti and meatballs preparation has been perfected by three generations of Sicilians, in both the old country and the new, and now passed on to a fourth generation, by me. I will stand by it to my dying breath.