LYON, France (AP) — 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.

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.

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.

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.

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.

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.

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.

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Sylvie Corbet in Paris contributed.