Yeah I have been running one. It's a really good case, made very well (as opposed to other polini products). Comes with an intake for a dellorto 15mm and for a 19/21mm. There are a lot of good cranks available -- if you get a polini bottom end then you should also get a good crank to go with it.
The polini bottom end will be better than modifying a stock case. Modifying a stock case is a lot of work because in grinding out a third port you hit some air pockets that need to be filled in with metal, plus the stock intake on the case sucks, the polini setup is bigger and has better flow.
Malossi also makes a case, I am getting one any day now and will be using that instead. I will most likely keep my polini case though.
The pedal thing you're talking about is not necessary, I've never used it so I can't say for sure, but apparently it causes a lot of friction and is basically something you would use in lieu of a polini or doppler tension spring. Basically, the stock tension spring isn't tough enough so the engine variates too quickly, and you can solve this problem by putting a tougher engine spring on (preferred option) or getting one of those pedals and manually forcing the engine forward.