I've worked with a number of hybrids and I have to admit that, in this case, performance usually IS directly proportional to circuit complexity. The best hybrids I've used are digital hybrids, such as that made by Gentner, until recently the leading US manufacturer of such devices (and now a victim of corporate acquisition... R.I.P).
The chief figure of merit in a hybrid is the degree of isolation between send and receive audio and is termed "trans-hybrid loss." A passive hybrid connected to a phone line cannot achieve high degrees of trans-hybrid loss across the frequency range of interest because the phone line impedance is not flat across the band. A good hybrid transformer with nulling components adjusted carefully can get you into the region of "good enough" on a good day.
For an example of a simple hybrid utilizing a transformer and op-amps, there was a serviceable but not stellar hybrid built into the Gentner Autocoupler.
Manual with schematic and theory of operation (337kB PDF)
At a previous job of mine, we used one of these to interface our television station production intercom to a similar intercom system at a news bureau several miles away via POTS (plain old telephone service). It did an OK job but required careful adjustment at initial setup. For on-air call-in use, though, we used higher-class Gentner hybrids.
The hybrid circuit in the Autocoupler is simple enough, though, to be attempted by the casual home experimenter. I can't say the same for the more sophisticated, higher-performance hybrids out there.
Also, it is instructive to study the two-wire to four-wire interface circuits in analog production intercom systems such as RTS "TW" and Clearcom "Party Line" products.
As PRR says, anything connected to the "nasty" Telco should indeed be transformer-isolated, even if you're doing the bulk of the work of the hybrid with active circuits.
Here's just a couple of examples of commercial hybrid transformers. There are many different models out there from several manufacturers.
http://rocky.digikey.com/WebLib/Parallax%20Pwr%20Comp(Magnetek)/Web%20Data/TY-302P.PDF
http://www.sowter.co.uk/specs/8321.htm