A French retired surgeon accused of sexually abusing over 300 young children over decades – primarily his patients in their hospital rooms — has been sentenced Thursday to 15 years in prison in the first trial of what may be the largest-ever pedophilia case in the country.

The trial this week in the western city of Saintes concerned four people allegedly targeted by Joel Le Scouarnec, 70, including two of his nieces, a young female neighbor, and a child who was hospitalized at age 4 in the establishment where he practiced.

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The judiciary files of retired French surgeon Joel Le Scouarnec are displayed on the opening day of his trial in the courthouse of Saintes, western France, Friday, March 13, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls – often on the operating table - goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

A French retired surgeon accused of sexually abusing over 300 young children over decades – primarily his patients in their hospital rooms — has been sentenced Thursday to 15 years in prison in the first trial of what may be the largest-ever pedophilia case in the country.
French police officers and lawyers gather in the entrance hall on the opening day of the trial "behind closed doors" of retired French surgeon Joel Le Scouarnec in the courthouse of Saintes, western France, Friday, March 13, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

During the trial, Le Scouarnec admitted he had raped his nieces.
View of the front entrance's sign Courthouse of Saintes, on the eve of the opening of retired French surgeon Joel Le Scouarnec's trial, in Saintes, western France, Thursday, March 12, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

About 30 other identified cases could not be brought to court, mostly because the alleged facts occurred too long ago to prosecute.
View of the Courthouse of Saintes, on the eve of the opening of retired French surgeon Joel Le Scouarnec's trial, in Saintes, western France, Thursday, March 12, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

In searching Le Scouarnec’s home, investigators uncovered more than 300,000 images of child and other pornography — as well as extensive notebooks where the surgeon detailed sexual violence against both girls and boys from 1989 to 2017. Next to each child’s name were comments on the nature of the sexual acts inflicted, according to investigators.
French police officer waits in the entrance hall on the opening day of the trial "behind closed doors" of retired French surgeon Joel Le Scouarnec in the courthouse of Saintes, western France, Friday, March 13, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

He also targeted older children in the operating room, when they were asleep or under anesthesia, according to his diaries.
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The judiciary files of retired French surgeon Joel Le Scouarnec are displayed on the opening day of his trial in the courthouse of Saintes, western France, Friday, March 13, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls – often on the operating table - goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

A French retired surgeon accused of sexually abusing over 300 young children over decades – primarily his patients in their hospital rooms — has been sentenced Thursday to 15 years in prison in the first trial of what may be the largest-ever pedophilia case in the country.

French police officers and lawyers gather in the entrance hall on the opening day of the trial "behind closed doors" of retired French surgeon Joel Le Scouarnec in the courthouse of Saintes, western France, Friday, March 13, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

During the trial, Le Scouarnec admitted he had raped his nieces.

View of the front entrance's sign Courthouse of Saintes, on the eve of the opening of retired French surgeon Joel Le Scouarnec's trial, in Saintes, western France, Thursday, March 12, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

About 30 other identified cases could not be brought to court, mostly because the alleged facts occurred too long ago to prosecute.

View of the Courthouse of Saintes, on the eve of the opening of retired French surgeon Joel Le Scouarnec's trial, in Saintes, western France, Thursday, March 12, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

In searching Le Scouarnec’s home, investigators uncovered more than 300,000 images of child and other pornography — as well as extensive notebooks where the surgeon detailed sexual violence against both girls and boys from 1989 to 2017. Next to each child’s name were comments on the nature of the sexual acts inflicted, according to investigators.

French police officer waits in the entrance hall on the opening day of the trial "behind closed doors" of retired French surgeon Joel Le Scouarnec in the courthouse of Saintes, western France, Friday, March 13, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

He also targeted older children in the operating room, when they were asleep or under anesthesia, according to his diaries.

Le Scouarnec has been found guilty of “rapes” and “sexual abuses,” Francesca Satta, the lawyer for the neighbor's family, told the AP. His name will also be added to the database of sex offenders, she said.

The judiciary files of retired French surgeon Joel Le Scouarnec are displayed on the opening day of his trial in the courthouse of Saintes, western France, Friday, March 13, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls – often on the operating table - goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

The judiciary files of retired French surgeon Joel Le Scouarnec are displayed on the opening day of his trial in the courthouse of Saintes, western France, Friday, March 13, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls – often on the operating table - goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

During the trial, Le Scouarnec admitted he had raped his nieces.

Other legal complaints against the doctor have piled up since the original investigation wrapped up.

Le Scouarnec has been charged in October on accusations of sexually abusing a total of 312 people — mostly children at the time — between 1986 and 2014 in several establishments were he used to work. Prosecutors said they include almost as many female as male, with an average age of 11.

French police officers and lawyers gather in the entrance hall on the opening day of the trial "behind closed doors" of retired French surgeon Joel Le Scouarnec in the courthouse of Saintes, western France, Friday, March 13, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

French police officers and lawyers gather in the entrance hall on the opening day of the trial "behind closed doors" of retired French surgeon Joel Le Scouarnec in the courthouse of Saintes, western France, Friday, March 13, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

About 30 other identified cases could not be brought to court, mostly because the alleged facts occurred too long ago to prosecute.

No date for a second trial has been set yet.

The first case reached investigators in 2017, when a 6-year-old neighbor told her mother that Le Scouarnec exposed himself and molested her across the fence between their properties.

View of the front entrance's sign Courthouse of Saintes, on the eve of the opening of retired French surgeon Joel Le Scouarnec's trial, in Saintes, western France, Thursday, March 12, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

View of the front entrance's sign Courthouse of Saintes, on the eve of the opening of retired French surgeon Joel Le Scouarnec's trial, in Saintes, western France, Thursday, March 12, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

In searching Le Scouarnec’s home, investigators uncovered more than 300,000 images of child and other pornography — as well as extensive notebooks where the surgeon detailed sexual violence against both girls and boys from 1989 to 2017. Next to each child’s name were comments on the nature of the sexual acts inflicted, according to investigators.

Le Scouarnec claimed his diaries included an element of fantasy.

Investigators say that under cover of medical acts, the doctor sexually took advantage of children as soon as they were alone in the hospital room. They say his strategy was to pass off sexual violence as a professional gesture, and to target patients so young they might not remember or understand what was happening.

View of the Courthouse of Saintes, on the eve of the opening of retired French surgeon Joel Le Scouarnec's trial, in Saintes, western France, Thursday, March 12, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

View of the Courthouse of Saintes, on the eve of the opening of retired French surgeon Joel Le Scouarnec's trial, in Saintes, western France, Thursday, March 12, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

He also targeted older children in the operating room, when they were asleep or under anesthesia, according to his diaries.

Questions arose during the trial about why nothing came out before and whether some people may have been aware of the alleged abuses.

The surgeon had already been sentenced in 2005 to a four-month suspended prison sentence for possession and importation of child pornographic images.

French police officer waits in the entrance hall on the opening day of the trial "behind closed doors" of retired French surgeon Joel Le Scouarnec in the courthouse of Saintes, western France, Friday, March 13, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

French police officer waits in the entrance hall on the opening day of the trial "behind closed doors" of retired French surgeon Joel Le Scouarnec in the courthouse of Saintes, western France, Friday, March 13, 2020. A retired French surgeon accused of raping or sexually abusing more than 300 girls, often on the operating table, goes on trial, in a case that took decades to come to light and may be France's worst single sexual abuse case to date. (AP PhotoFrancois Mori)

Investigations have determined that Le Scouarnec rubbed shoulders with two other doctors, one convicted for possession and dissemination of child pornographic images in the western region of Brittany, and another convicted for sexual abuse of children in the southwestern town of Jonzac, where the surgeon later moved.

Sylvie Corbet in Paris contributed.