Amélie knew something was off about her surgery. Then her name turned up in a notebook.

Amélie Lévêque remembered crying a lot when she was in hospital at the age of nine in 1991.

She had gone in for a simple appendix removal surgery, yet trauma followed her for decades. She suffered bouts of depression, eating disorders, and a phobia of hospitals. For years, she lived with an unease she couldn't explain.

Since her operation, her life had felt "suspended".

She never knew why, until one day in 2019.

A shocking discovery.

Reading the news, Amélie stumbled upon the horrific case of a surgeon under investigation on suspicion of sexually assaulting patients, most often minors, over three decades.

The surgeon, Joël Le Scouarnec, allegedly meticulously catalogued the abuse in digital diaries.

In one entry, Amélie was named.

"Immediately I knew, voilà, that's what happened to me," she told AFP.

She contacted a lawyer, Francesca Satta, who confirmed Amélie was one of the victims. And as if a door had unlocked, memories began to trickle through, slowly.

"Nights and days, I thought about nothing else. I had a big, big depression. I didn't know who I was, where I lived, or what was happening to me anymore," she said.

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France's largest child sex abuse trial.

Now 42, Amélie is set to testify at France's largest-ever child sex abuse trial, which opened on Monday in Vannes, in the picturesque Brittany region.

Le Scouarnec, now 74, is accused of raping or sexually abusing 299 people, mostly child patients. Prosecutors said he has admitted to many, but not all, of the charges.

Defendants in France are brought to trial even if they admit guilt. The former surgeon will face hundreds of victims during the four-month trial.

Some survivors have no memory of the assaults, having been unconscious at the time of undergoing surgery at Le Scouarnec's hands.

Seven days of testimony from victims will be held behind close doors. Amélie is the only one to agree to testify with her face uncovered.

On March 7, she will finally come face-to-face with her abuser again.

Thirty-four years on, she expects "absolutely nothing" from her abuser.

"On the other hand, I know that I will probably never see him again and that this is the last time I will be able to speak to him. I especially do not want to have any regrets," she told La Montagne.

"I have nothing to be ashamed of. Everyone does what they can, what they want. But in my case, speaking out was quite liberating."

Amélie Lévêque has agreed for her identity as a victim to be made public. Image: RTL Info.

How were Le Scouarnec's crimes discovered?

The case began in 2017 when a six-year-old neighbour denounced Le Scouarnec, who had touched her over the fence separating their properties.

A subsequent search of his home uncovered more than 300,000 photos, 650 pedo-pornographic, zoophilic and scatological video files, as well as notebooks where he described himself as a paedophile and detailed his actions, according to investigation documents.

In his notes, he described himself as a "major pervert", admitting, "I am very happy about it", according to France24.

In 2020, Le Scouarnec was sentenced to 15 years in prison for the rape and sexual assault of four children, including two nieces and a young patient.

He admitted to child abuse dating back to 1985 to 1986, according to investigation documents. Some cases couldn't be prosecuted, because the statute of limitations had expired.

The Vannes trial will examine rapes and other abuses committed from 1989 to 2014 on 158 men and 141 women who were aged 11 on average at the time.

The doctor sexually abused both boys and girls when they were alone in hospital rooms, according to the investigation documents. His strategy was to disguise sexual violence as a medical act, targeting young patients who were less likely to recall what had happened.

Missed warnings.

The case could have come to light much earlier.

Le Scouarnec had already been convicted in 2005 for possessing and importing child pornography and sentenced to four months of suspended prison time.

Despite this, he was appointed as a hospital practitioner the next year.

Another opportunity was missed in June 2006 when a psychiatrist at the hospital where Le Scouarnec worked in Quimperlé learned of his conviction and wrote a letter alerting the hospital director. The director passed it along to the local medical board and ordered that the surgeon be accompanied whenever he was with minors, according to France Info.

However, the order was never carried out, according to NBC. Le Scouarnec went on to abuse at least 54 more victims between 2004 and 2017.

NBC reports not all of the victims in the diaries have been pursued by investigators. Journalist Hugo Lemonier — who spent three years researching a new book about the case, Trapped: In the Intimate Diaries of Dr. Le Scouarnec — alleged that the estimated true number of victims could exceed 400.

A courtroom sketch of Joel Le Scouarnec, now 74, sitting in courtroom and accused of raping or abusing 299 people, mostly child patients. Image: AAP.

Seeking closure.

Le Scouarnec faces up to 20 years in prison for rape, sexual assault and indecent acts committed with violence or surprise.

For Amélie, sentencing will provide a sense of closure for the atrocities that still haunt her to this day.

"When the verdict comes down, I would like to be able to say to myself: 'That's it, it's over, it's behind me'," she told La Montagne.

"And at the same time, this 'after' scares me, because I know that his shadow will always be there, somewhere, behind me."

"I don't want to fall back into depression. I don't want to screw everything up because of him. I'm really on a tightrope, in fact."

But she's still walking. And that's what matters.

-with AAP

Feature image: AAP.