My doctor and I 'had the talk', and he recommended the Rouen-Y for me also (this is a highly recommended doctor). He based his recommendation on a few factors:
1. I'm young and healthy (besides the obvious 297 lbs!) So, I can tolerate the surgery (no complications like diabetes,etc.)
2. I need a life-change; he says the band has a lifespan of about 15 yrs, and then it needs to be removed/replaced. At my age, that would mean several replacements, to manage my weight.
In my research I found that the Rouen-Y has been around, and studied for something like 60yrs, and that is part of why the insurance does cover it... it's what they know. So, even though there are risks (like with all surgeries) they are still relatively low.
You have to ask a lot of questions (look for forums with recommended questions to ask your surgeon), and make a decision based on what you feel comfortable with.
*** Keep in mind, it can also be done laparoscopically too. My surgeon is going to do mine through the same type 'portals' as he uses for LapBanding. There won't be big scars, or a 'grand opening' of me! LOL. He said that usually only occurs when the person is over a certain size or complications.
Don't worry... ask more questions. All the best!