If you are relatively handy and have some mechanical tools, it's not complicated.
I work mostly on Merc, just happen to own a 140 Ev, so working here from limited memory of when I redid my motor.
The grommet is mounted in the exhaust housing (not the plate which the power head is bolted to). I'm thinking you can get the housing out through the bottom of the leg (with the lower unit removed) - it's bolted in from the underside (threads go into the plate towards the powerhead).
So a bit of jigging around, and a manual would definitely be of great assistance, but something you could do with a socket set and an hour or two of your time.
The grommet sells for about 5 bucks - it would be a shame to pay a hundred dollar service charge (or more) for a 5 buck part...