A former surgeon is to go on trial in France on Monday charged with raping or sexually assaulting almost 300 former patients, most of them children.

Joel Le Scouarnec, 74, is already in jail after a court in 2020 found him guilty of abusing four children, including two of his nieces.

In the latest trial, to last four months, he faces allegations that he also assaulted or raped 299 patients, many while waking up from anaesthetic or during post-op checkups, at a dozen hospitals between 1989 and 2014.

In total, 256 of the 299 victims were under 15, with the youngest aged one and the oldest aged 70.

The trial is likely to be a new shock for France.

It comes just two months after Frenchman Dominique Pelicot was convicted of enlisting dozens of strangers to rape his heavily sedated wife Gisele Pelicot, who has since divorced him and become a feminist hero for refusing to be ashamed.

In this case, Le Scouarnec is the sole defendant accused of crimes against hundreds of victims.

The trial in the city of Vannes in the western region of Brittany will be held in public, but seven days of testimony from victims who were targeted while minors will be held behind closed doors.

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If convicted, Le Scouarnec faces a maximum sentence of 20 years in prison — French law does not allow sentences to be added together even when there are multiple victims.

The surgeon practised for decades until his retirement despite a 2005 sentence for owning sexually abusive images of children and colleagues raising their concerns.

Le Scouarnec was practising in the western town of Lorient in 2004 when the FBI alerted French authorities that he was among hundreds in France who had been consulting sex abuse images of children online.

A court in nearby Vannes handed him a suspended four-month jail sentence the following year.

But by that time the doctor had already moved on to work in another Brittany town, Quimperle, where he was promoted despite the management being made aware of his conviction.

He then moved to southwestern France, where he worked until his retirement in 2017.

Investigators uncovered his alleged crimes after he retired in 2017, when a six-year-old girl accused him of rape and police found accounts of abuse in his diaries.

Victims and child rights advocates say the case highlights systemic shortcomings that allowed Le Scouarnec to repeatedly commit sexual crimes.

Frederic Benoist, a lawyer for French advocacy group La Voix de l’Enfant (The Child’s Voice), said the fact Le Scouarnec was never barred from practising was the result of “collective failure”.

A separate investigation has been opened by regional prosecutors over these failures, though it is not yet targeting any individual or institution.