TORONTO -- An anesthesiologist was sentenced to 10 years in prison Tuesday for what a judge called "reprehensible" sexual assaults on 21 sedated women during surgeries -- violations that left his victims with lasting emotional damage.

Dr. George Doodnaught, 65, exploited the extraordinarily high degree of trust the patients placed in him, said Ontario Superior Court Justice David McCombs.

"The profound psychological impact of the physical violations has been compounded by the victims' deep feelings of betrayal -- that these offences were committed during surgery, by a medical doctor, in an operating room, a place of ultimate vulnerability and trust," McCombs said in sentencing Doodnaught.

"His conduct did enormous damage and was reprehensible in the extreme."

Many of Doodnaught's victims were in the courtroom and wiped tears from their eyes as the sentence was read. Their victim impact statements at an earlier sentencing hearing told of "debilitating" feelings of anger and bitterness, shame, panic attacks, loss of self-worth, distrust of doctors and an inability to form intimate relationships, McCombs said.

"In several cases (Doodnaught) compounded his victims' sense of violation and humiliation by manipulating them to try to make them believe they were somehow responsible -- that they had initiated sexual contact or had engaged in sexually explicit conversations," McCombs said.

Though Doodnaught was sentenced to 10 years, he may not spend much time in custody. Doodnaught intends to appeal his convictions, and the Court of Appeal for Ontario is set to hear an application Wednesday to let him out on bail pending the appeal.

He was on bail throughout the trial, so his victims stayed in the courtroom after the sentence was read to see the handcuffs slapped on and the disgraced doctor led out of the room.

One of his victims -- the one who sparked the investigation -- clapped as he was led away. Outside court she said the prospect of more court hearings as Doodnaught proceeds with his appeal is "devastating," but she will keep attending and fighting to be heard.

"At this point I've come this far and I need to show my children how to do the right thing and how to stand up (against) what's wrong and this is so wrong on so many levels and I need to do that for them," she said with her husband by her side.

The woman, who can't be identified due to a publication ban, had a mass on several organs when she went in for a hysterectomy in 2010. During the surgery Doodnaught fondled her breasts, kissed her and put his penis in her mouth, the court found.

When she was in the recovery room, Doodnaught leaned in close to her and said, "As soon as you were out, the first thing you reached for was my...(penis)," the court found.

Doodnaught declined the opportunity to make a statement before he was sentenced, which the victim said was telling.

"Never once during this whole process, even when I was on the stand, when I was giving my victim impact statement, at any time, did he look at me," she said outside court. "He's a coward."

Doodnaught's lawyer, Brian Greenspan, said his client was "disappointed" with the sentence.

"He continues to enjoy widespread support not only with his family but amongst his colleagues, patients," he said outside court.

The judge noted that the defence filed 49 letters of support from Doodnaught's family, former colleagues, patients and friends.

"They are uniformly shocked that the man they know has been found to have committed these crimes," McCombs said.

"His family members and supporters describe him as a modest, caring and loving person and a supportive and generous mentor, who took great pride in his work as an anesthesiologist and most of all, in his family."

When Doodnaught was convicted in November, McCombs found the doctor relied on his three decades of operating room experience to avoid detection as he kissed women, fondled their breasts and put his penis in their mouth or hand.

Doodnaught was known as a "touchy feely" doctor, often stroking a patient's cheek or hair to soothe them during surgery, so the judge found his physical proximity during surgery didn't arouse suspicion with other staff even as he sexually assaulted the women while concealed only by a surgical drape.

It is a unique set of circumstances in Canadian law, McCombs said Tuesday.

"There are no reported Canadian cases in which an anaesthesiologist sexually assaulted sedated patients in an operating room during surgery," he said.

All but one of the assaults took place at the North York General Hospital in Toronto. They became more frequent until Doodnaught was caught, with the first six spread over three and a half years and 15 others in the last six months before he was stopped.

The hospital told Doodnaught to take a leave of absence after the last woman he assaulted went to police.

His medical licence was suspended but the College of Physicians and Surgeons still has to hold a disciplinary hearing which could lead to it being revoked.

The hospital's CEO has apologized on behalf of the medical facility to all of the victims for the impact Doodnaught's crimes had on their lives. The hospital has since made changes to how it addresses and tracks patient complaints.