France is preparing for its largest-ever child abuse trial as a former surgeon stands accused of sexually assaulting 299 children.

On Monday, Joël Le Scouarnec, now 74, will stand trial in a horrific case of paedophilia that involved various acts of sexual abuse against hundreds of children while he practised medicine at hospitals across western France.

Often the children were under anaesthesia, but some acts were committed during medical examinations or as the victims were recovering. The 745-page indictment lists 158 men and 141 women, who were all under the age of 15 at the time of the events between 1989-2014.

Le Scouarnec faces 20 years imprisonment for aggravated rape and aggravated sexual assault. The trial will be held at a courtroom in Vannes, northwestern France, over four months.

Meticulous handwritten records

The accused kept meticulous records, both on computer files and in handwritten notebooks. Some of his journal entries were written like love letters to his victims “Dear little Celine”, “Guillaume, adorable little boy”, and “Xavier, my darling how beautiful you were.”  He also recorded where the acts took place (in the patient’s room or the operating room), the victim’s age, date of birth and address, and the nature of the abuse he committed.

In his journals, the former doctor wrote about zoophilic fantasies he claimed to have practised and expressed incestuous fantasies about his nieces and and his granddaughter.

In a search of his home, investigators discovered dolls that were sexualised and more than 50,000 images and 5,000 violent videos of child pornography.