It is "simply impossible" that an anesthesiologist accused of molesting 21 women during surgeries would have been able to do so undetected by anyone else in the operating rooms, his lawyer told a judge Tuesday during his closing arguments.

Dr. George Doodnaught has pleaded not guilty to 21 counts of sexual assault. The women reported that he kissed them, touched them inappropriately or put his genitals in their mouth while they were under conscious sedation, all but one during surgeries at North York General Hospital between 2006 and 2010.

But Doodnaught's lawyer, Brian Greenspan, said in his closing submissions to Ontario Superior Court Justice David McCombs at the judge-alone trial that the women are mistaken. What they thought happened was an effect of the sedation, he said.

There were 143 other people in the room during those 21 surgeries and none reported seeing evidence of sexual misconduct, Greenspan said.

"There's scores of people who see nothing and hear nothing and we're not talking about a hockey arena — we're talking about an operating room and some of which are terribly small," he said.

"One-hundred and forty-three people saw no evil, heard no evil. Not that they were trying to avoid seeing or hearing evil — there was no evil to be seen, no evil to be heard."

The doctors who performed the surgeries didn't report any suspicious movement by the patients or coming from behind the draping sheets during the surgeries.

"All of that is simply unseen, unheard?" Greenspan said.

"Impossible, simply impossible."

Certain movements that take place during surgeries "could so easily be misinterpreted in a state of clouded consciousness," Greenspan said. Adjusting the position over the chest area of leads that monitor heart activity could be mistaken for a hand touching a breast, he suggested.

It was Doodnaught's practice to hold a patient's hand during surgery, Greenspan said. While under sedation, fingers could be easily mistaken for a penis, he said. Some of the women reported feeling Doodnaught's penis in their hand as they drifted in and out of consciousness.

One doctor reported hearing a patient say "take that out of my mouth" during her surgery, but the doctor "rightly assumed" she was referring to a cloth Doodnaught often used to moisten a patient's mouth during surgery or to an airway that was inserted, Greenspan said.

McCombs suggested to Greenspan that a surgeon would be so focused on the task at hand that they would have zoned almost everything else out.

"Every child buried in a video game knows what I'm talking about," the judge said.

But Greenspan said that focus would make them more highly attuned, if anything, to a movement of the patient's body or the draping sheet.

The Crown is expected to present closing submissions Wednesday.