A former surgeon went on trial in western France on Monday on charges that he raped or sexually assaulted hundreds of people, most of them former pediatric patients7xm, in what is widely considered the biggest pedophilia case in French history.

The former surgeon, Joël Le Scouarnec, 74, is accused of raping or sexually assaulting 299 people over 25 years, from 1989 to 2014. Almost all the victims are his former patients, and almost all of them were children at the time of the alleged abuse. The average age of the patients he is accused of sexually assaulting was 11.

“I have committed heinous acts,” Mr. Le Scouarnec told the court as the trial opened in the coastal town of Vannes, in Brittany.

Wearing a black vest, with a bald head and a ring of white hair on the back and sides, he mumbled at first, then spoke more clearly,x777 casino as he acknowledged responsibility for some of the alleged rapes and sexual assaults, although he said that other acts he was accused of did not fall under those categories.

Referring to his victims, he said that he was “perfectly aware that these wounds today are indelible, irreparable” and that he owed it to them to “take responsibility for my actions and the consequences they may have had.”

Mr. Le Scouarnec faces a maximum of 20 years in prison if convicted, because there are no consecutive sentences in France. The rape charges are mostly related to penetration with fingers, which reflects the definition of rape in France.

We are having trouble retrieving the article content.

Please enable JavaScript in your browser settings.

Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.

Thank you for your patience while we verify access.

Already a subscriber? Log in.

Want all of The Times? Subscribe.

Among national universities, Princeton was ranked No. 1 again, followed by the Massachusetts Institute of Technology and Harvard. Stanford, which tied for third last year, fell to No. 4. U.S. News again judged Williams College the best among national liberal arts colleges. Spelman College was declared the country’s top historically Black institution.

Calls for school crackdowns have mounted with reports of cyberbullying among adolescents and studies indicating that smartphones7xm, which offer round-the-clock distraction and social media access, have hindered academic instruction and the mental health of children.