France has opened its most extensive child sex abuse trial, with former surgeon, Joël Le Scouarnec accused of raping or sexually abusing 299 people, most of whom were child patients.

The trial, which started on Monday in Vannes, Brittany, is expected to last four months, with hundreds of victims confronting the 74-year-old defendant, who has not denied the charges but claims not to remember everything.

At the heart of the case are Le Scouarnec’s meticulously detailed notebooks, where he documented decades of sexual violence.

Some victims only learned of their abuse after investigators uncovered the records, as they had been unconscious under anesthesia during the assaults.

The case first emerged in 2017 when a six-year-old girl accused Le Scouarnec of touching her over a fence. A search of his home led to the discovery of over 300,000 photos, hundreds of disturbing video files, and his handwritten accounts of abuse.

In 2020, he was sentenced to 15 years in prison for raping and sexually assaulting four children, including two of his nieces and a young patient.

The Vannes trial covers offences committed between 1989 and 2014 against 158 men and 141 women, who were, on average, 11 years old at the time. The abuse reportedly took place in hospitals, where Le Scouarnec disguised sexual violence as medical procedures, targeting children unlikely to recall what had happened.

One survivor, Amélie Lévêque, recounted how she had only vague memories of her hospital stay at the age of nine in 1991.

“I didn’t really remember the operation. I remembered the postoperation, a surgeon who was quite mean,” she said. Learning that her name was listed in Le Scouarnec’s notebooks was both a revelation and a trauma.

“That was the beginning of the answers to a lifetime of questions, and then it was the beginning of the descent into hell as I left the lawyer’s office,” she said. “I felt like I had lost control of everything. I wasn’t crazy, but now I had to face the truth of what had happened.”

Despite Le Scouarnec’s 2005 conviction for possessing child pornography, he continued practising as a hospital surgeon. Bureaucratic delays meant that health authorities were not immediately aware of his record, and even after learning of it, they failed to take disciplinary action.

Activists and child protection groups view the trial as a turning point in exposing longstanding failures in addressing sexual abuse in medical and institutional settings.

The Independent Commission on Incest and Sexual Violence against Children has called for urgent reform, stating, “Child abuse careers are built, not by monsters, but by all witnesses’ successive silences.”

Le Scouarnec’s lawyer, Thibaut Kurzawa, told Sud-Ouest newspaper that his client would “answer the judges’ questions” as he has chosen “to face up to reality.”

Meanwhile, victims and advocacy groups hope the trial will drive lasting change in how society protects children from abuse.

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